Rheolytic Catheter and Thrombolysis of Dural Venous Sinus Thrombosis: A Case Series

Baker, Michael; Opatowsky, Michael J.; Wilson, John A.; Glazier, Steven S.; Morris, Pearse

doi:10.1097/00006123-200103000-00005

Cited by 58 publications

(53 citation statements)

References 11 publications

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“…It exhibits a variety of symptoms mechanical thrombofragmentation using devices such as the microsnare, mechanical thrombectomy using a stent retriever, and thromboaspiration using the Penumbra aspiration system. [4][5][6][7] Methods such as thromboaspiration combined with conventional thrombolytic therapy, mechanical thrombofragmentation, and mechanical thrombectomy have also been reported. [8][9][10][11][12][13][14][15] According to the systematic review of endovascular treatment for CVST performed at 42 institutions (185 cases) between January 1995 and February 2014 by Siddiqui et al, the mainstay of treatment was AngioJet (40%), followed by the snare (31%), balloon angioplasty (25%), and Penumbra system (7%), and endovascular treatment with that of heparin anticoagulant therapy is in progress, and its results are awaited.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Cerebral Venous Sinus Thrombosis Successfully Recanalized by the Concomitant Use of an Aspiration through the Guiding Catheter and Stent Thrombectomy Device

Bando

Kuramoto

Shinoda

et al. 2018

JNET

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Objective: Two cases of cerebral venous sinus thrombosis (CVST) effectively recanalized endovascularly by a combination of thromboaspiration using Cerulean catheter DD6 and stent retriever device are reported. Case Presentations:We endovascularly treated two cases of CVST that presented with progressive vomiting and disturbance of consciousness several days before the diagnosis of occlusion of the main venous sinus and venous congestion. The thrombus was removed by the combined use of an aspiration system made of Cerulean catheter DD6 connected to the Penumbra aspiration pump and a Solitaire FR thrombectomy device. In one case, balloon thrombofragmentation was performed with local thrombolytic therapy. In both cases, the occluded venous sinus was recanalized, venous congestion was resolved, and early initiation of anticoagulation therapy was possible. After the procedure, neurologic symptoms disappeared, and both patients were discharged 16 days after the procedure with a modified Rankin Scale (mRS) score of 0. Conclusion:In CVST, thromboaspiration by the concomitant use of a Cerulean catheter DD6 and a stent retriever is considered an effective therapeutic approach.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Cerebral Venous Sinus Thrombosis Successfully Recanalized by the Concomitant Use of an Aspiration through the Guiding Catheter and Stent Thrombectomy Device

Bando

Kuramoto

Shinoda

et al. 2018

JNET

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“…Previously, mechanical thrombolysis was exclusively performed for patients with severe manifestations (Table 1). 1,4,6,[8][9][10][11] Fibrin is the main component of the thrombus responsible for sinus thrombosis. Local thrombolytic therapy with fibrinolytic agents, such as urokinase and recombinant tissue plasminogen activator, is performed as a proactive treatment for sinus thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Thrombolysis for Treatment of Acute Sinus Thrombosis-Case Report-

Yamashita

Matsumoto

Tamiya

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A 55-year-old woman presented with consciousness disorders. Computed tomography revealed hemorrhage in the left temporoparietal region. The angiographic diagnosis was progressive sinus thrombosis from the superior sagittal sinus to the bilateral transverse sinuses. Her condition deteriorated despite heparin administration. Therefore, mechanical thrombolysis was performed for sinus thrombosis using a balloon catheter, in addition to supportive thrombolytic therapy with urokinase, resulting in sinus patency. Mechanical thrombolysis is an effective therapeutic modality for sinus thrombosis refractory to heparin administration.

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“…DISCUSSÃO TSD é uma condição devastadora, algumas vezes letal e freqüentemente de difícil diagnóstico e trat a m e n t o 5 . Afeta mais comumente pessoas jovens, de média idade e do sexo feminino 7 , 1 4 , 1 5 .…”

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“…Estima-se que a incidência anual seja de três a quatro casos por um milhão de adultos e até sete casos por um milhão de cria n ç a s 2 . A taxa de mortalidade varia de 5% a 30% 3,4 em decorrência da demora no seu diagnóstico e pela ausência de sinais e sintomas patognomônicos 5,6 . O quadro neurológico mais freqüente consiste de cefaléia, déficits focais, convulsões, distúrbios de consciência e papiledema 6 , 7 .…”

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Trombose de seio dural: relato de caso

Falavigna

Pontalti²,

Teles

2006

Arq. Neuro-Psiquiatr.

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RESUMO -Relata-se o caso de uma gestante de 24 anos, encaminhada ao serviço de neurologia por a p resentar agitação, alucinações, confusão mental, cefaléia, perda de visão, afasia e convulsões. Exame n e u ro rradiológico compatível com trombose de seios durais e veias corticais. Foi realizado tratamento com abciximab e efetuada a lise mecânica do trombo obtendo restauração do fluxo venoso cerebral. Após o procedimento, apresentou hematoma frontal o qual foi retirado cirurgicamente. A paciente evoluiu com melhora neurológica pro g ressiva. Discute-se esta infreqüente patologia segundo quadro clínico, patogênese, exames de imagem e terapêutica.PALAVRAS-CHAVE: trombose, seios durais, veias cerebrais, trombólise. Dural sinus thrombosis: case reportABSTRACT -We re p o rt the case of a 24 year-old pregnant womam, seem at the neurology service by p resenting agitation, hallucinations, mental confusion, headache, vision loss, aphasia and seizures. The n e u ro rradiologic exam was compatible with thrombosis in dural sinus and cortical veins. Treatment with abciximab was accomplished and the mechanical lysis of the thrombus was made obtaining restoration of cerebral vein flow. After the procedure, she presented frontal hematoma wich was withdrawn surgically. We discuss this infrequent pathology in clinical picture, pathogenesis, image exams and therapeutics.KEY WORDS: thrombosis, dural sinus, cerebrais veins, thrombolisis. ceptivos orais, traumatismo cranioencefálico, lesão d i reta dos seios ou veia jugular, procedimentos neuro c i r ú rgicos, punção lombar e de várias outras circ u n s t â n c i a s 1 , 2 , 8 , 9 . Condições pro t rombóticas here d i t á-rias, como fator V de Leiden, deficiência das pro t e í n a s C e S e antitrombina III contribuem com 10% a 15% dos casos de TSD 10,11 . O tratamento da TSD visa a recanalizar o seio tro mbosado, o que pode ser obtido com terapia anticoagulante ou trombolítica. A terapia trombolítica pode ser sistêmica ou local. A administração no local da tro mbose pode ser feita por via intravenosa através de cat e t e r 5 ou por via transcraniana , com objetivo evitar uma extensão maior do t rombo, favorecer sua dissolução espontânea e pre v e n i r embolismo pulmonar 5 , 1 3 . Relatamos um caso de TSD. CASOMulher de 24 anos, no primeiro trimestre de gestação, Trombose de seio dural (TSD) é relativamente incomum e, nos últimos tempos, tem sido mais fre q ü e ntemente detectada em razão dos avanços das técnicas não invasivas de diagnóstico 1 . Estima-se que a incidência anual seja de três a quatro casos por um milhão de adultos e até sete casos por um milhão de cria n ç a s 2 . A taxa de mortalidade varia de 5% a 30% 3,4 em decorrência da demora no seu diagnóstico e pela ausência de sinais e sintomas patognomônicos 5,6 . O quadro neurológico mais freqüente consiste de cefaléia, déficits focais, convulsões, distúrbios de consciência e papiledema 6 , 7 . O modo de início da TSD é variável, e esse distúrbio pode mimetizar infarto isquêmico ou hemorrágico, abscesso, tumor, encefalite,...

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Rheolytic Catheter and Thrombolysis of Dural Venous Sinus Thrombosis: A Case Series

Abstract: Mechanical clot lysis is a powerful technique for immediate restoration of antegrade venous flow in dural sinus thrombosis. In most patients, the superior sagittal sinuses and contralateral transverse sinuses could be accessed with the 5-French rheolytic catheter.

Cited by 58 publications

References 11 publications

Two Cases of Cerebral Venous Sinus Thrombosis Successfully Recanalized by the Concomitant Use of an Aspiration through the Guiding Catheter and Stent Thrombectomy Device

Two Cases of Cerebral Venous Sinus Thrombosis Successfully Recanalized by the Concomitant Use of an Aspiration through the Guiding Catheter and Stent Thrombectomy Device

Mechanical Thrombolysis for Treatment of Acute Sinus Thrombosis-Case Report-

Trombose de seio dural: relato de caso

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