Abstract Number ‐ 92: Successful thrombectomy with Indigo Aspiration System on diffuse cerebral sinus thrombosis

Abstract

Introduction Endovascular treatment for venous sinus thrombosis is challenging. Commonly utilized aspiration catheters in neuro‐interventional procedures have diameters ranging from 2–3 mm and are much smaller than the average diameter of the major cerebral venous sinuses. Penumbra’s Indigo Aspiration System (Penumbra Inc., Place Alameda, CA) is a trackable, large‐lumen (Indigo System CAT7, 7F) catheter and aspiration system that is used for aspiration of thrombi and emboli involving the peripheral venous and arterial systems, as well as pulmonary emboli. Here, we show that this large‐lumen system may safely retrieve and successfully recanalize cerebral venous thrombosis (CVT), addressing the problem of available tools for complete thrombus removal. Methods Case report. I wanted to submit this abstract for: ‐Young Investigator Award ‐Best Scientific Abstract Award Results Here, we present the first reported case of successful endovascular thrombectomy of cerebral venous sinus thrombosis utilizing Penumbra’s Indigo System (Penumbra Inc., Place Alameda, CA), a minimally‐invasive system with a large‐lumen (Indigo System CAT7, 7F) catheter predominantly used for the removal of thrombi and emboli involving the peripheral arterial and venous systems and for the treatment of pulmonary embolism. A 30‐year‐old female presented with a hemorrhagic infarct of the left posterior temporal lobe secondary to an extensive cerebral venous thrombosis (CVT) extending from the left transverse sinus to the ipsilateral internal jugular bulb. In addition to a continuous heparin infusion, we performed an endovascular thrombectomy with the device mentioned above, resulting in a technically successful radiographic recanalization of the involved sinuses. The patient was discharged home in a stable condition. This case demonstrates that this trackable, atraumatic, large‐bore system can be safe and efficacious, permitting near complete thrombus removal. Conclusions Cerebral Venous Thrombosis (CVT) recanalization is an important outcome measure in trials investigating endovascular therapies for dural venous sinus clots.Most endovascular tools used for aspiration of CVT are designed for arterial, not venous, vasculature.Penumbra’s Indigo Aspiration System, a large‐lumen catheter can be considered as a valid, safe, and effective alternative for the treatment of diffuse CVT.