Dual-Stent retriever thrombectomy for extensive dural sinus thrombosis

Byer, Stefano H.; Madarang, E. John; Abraham, Michael

doi:10.1080/00207454.2022.2080675

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Although AIS and CVT are fundamentally different diseases, the current situation of EVT for CVT in some ways resembles the setting of EVT for acute ischemic stroke a decade ago, when early EVT trials failed to show benefit. The knowledge of technical aspects of MT in CVT has significantly grown through the years, allowing neurointerventionalists to perform safer and more effective procedures, primarily deriving from the advancement in perfecting arterial thrombectomies [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Cerebral Vein Thrombosis: Safety and Effectiveness in the Thrombectomy Era

et al. 2023

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Cerebral venous thrombosis (CVT) is a rare cause of stroke that tends to affect young people. Endovascular treatment (EVT) has not yet shown to be beneficial in CVT and is therefore actually only indicated as rescue therapy in severe and refractory cases for medical treatment. Clinical, neuroimaging, procedural and follow-up data were evaluated in order to define the safety and efficacy of EVT in the management of CVT between January 2016 and December 2022. Safety was assessed on the basis of recording adverse events. Functional outcomes (NIHSS, mRS) and neuroimaging were recorded at onset, at discharge and at a 6-month follow-up. Efficacy was assessed evaluating the recanalization rate at the end of the procedure. Twenty-one patients (17 female, 4 male, range 16–84 years) with CVT underwent EVT. Overall morbidity and mortality were both at 4.7%. Median NIHSS at the onset and at the discharge were, respectively, 10 and 2. Successful recanalization was achieved in 21/23 procedures (91.3%). Imaging follow-up (FUP) showed stable recanalization in all but one patient with successful recanalization. In 18/21 patients, a good clinical independence (mRS 0–2) was recorded at 6 months. Our study adds evidence on the safety and efficacy of endovascular techniques in the treatment of CVT.

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Cerebral Vein Thrombosis: Safety and Effectiveness in the Thrombectomy Era

et al. 2023

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“…Although double SRT can capture a large portion of the thrombus at once, there is a high risk of hemorrhagic complications due to the substantial displacement of blood vessels by the two stent retrievers. Most previous reports have been cases where double SRT was performed for intracranial LVO (Klisch et al, 2015;Asadi et al, 2016;Li et al, 2020;Jiang et al, 2021;Xu et al, 2021;Sasaki et al, 2022) or dural sinus thrombosis (Byer et al, 2022). However, when hemorrhagic complications occur in intracranial vessels, the fatal outcome of subarachnoid hemorrhage often follows, and thus, using double SRT as first-line MT is challenging.…”

Section: Introductionmentioning

confidence: 99%

Parallel stent retriever mechanical thrombectomy of an acute internal carotid artery occlusion refractory to standard techniques: A case report

Yoshimoto

Hosoki²,

Tanaka³

et al. 2023

Front. Stroke

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Although mechanical thrombectomy for acute large vessel occlusion is generally effective, some occlusions are refractory. We report a patient in whom the parallel stent retriever technique using two Trevo stent retrievers (Stryker Neurovascular, Fremont, California, USA) was required to treat an intracranial and epidural internal carotid artery occlusion after other techniques had failed. A 68-year-old woman presented with an acute left internal carotid artery occlusion 4 days after mechanical thrombectomy of a left middle cerebral artery occlusion. She was not a candidate for intravenous thrombolysis because of a recent cerebral infarction. Attempts at mechanical thrombectomy using a stent retriever, contact aspiration, or combined contact aspiration and stent retriever were unsuccessful. The parallel stent retriever technique using two 6 × 25-mm Trevo stent retrievers enabled coverage of the entire thrombus, and successful reperfusion was achieved (extended Thrombolysis in Cerebral Infarction grade 2b). After the procedure, the patient was able to walk without assistance. Her modified Rankin Scale score was 2 at 90 days follow-up. Microscopic examination of the retrieved thrombi demonstrated red blood cells, fibrin, and partial endothelialization. The parallel Trevo stent retriever technique has the potential as rescue therapy for refractory large-vessel occlusion. However, complications arising from this technique remain uncertain. Further studies are needed to determine the effect of this technique in terms of recanalization and clinical safety.

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Dual-Stent retriever thrombectomy for extensive dural sinus thrombosis

Cited by 2 publications

References 15 publications

Endovascular Treatment of Cerebral Vein Thrombosis: Safety and Effectiveness in the Thrombectomy Era

Endovascular Treatment of Cerebral Vein Thrombosis: Safety and Effectiveness in the Thrombectomy Era

Parallel stent retriever mechanical thrombectomy of an acute internal carotid artery occlusion refractory to standard techniques: A case report

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