Republished: A novel combined approach using a Penumbra catheter and balloon catheter for cerebral venous sinus thrombosis

2018 ◽  
Vol 11 (9) ◽  
pp. e6-e6
Author(s):  
Yoshikazu Matsuda ◽  
Yoshihiro Owai ◽  
Koji Kakishita ◽  
Naoyuki Nakao
Keyword(s):  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Balloon Catheter ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dramatic Improvement ◽  
Combined Approach ◽  
Venous Sinus Thrombosis ◽  
Inflated Balloon ◽  
The Right

Cerebral venous sinus thrombosis is sometimes fatal. We describe a case of sinus thrombosis in a 43-year-old woman presenting with generalized seizure, delirium, and a 2 week history of headache and nausea. The patient underwent mechanical thrombectomy using a novel combined approach, in which a Shouryu HR balloon catheter (Kaneka) was anchored in the right transverse sinus (TS), sigmoid sinus (SS), and superior sagittal sinus (SSS), while a Penumbra 5 MAX ACE (Penumbra) catheter was moved back and forth between the right TS, SS, and SSS. Additionally, back and forth movement of the inflated balloon with aspiration—the so-called ‘dental floss technique’—was performed. Partial recanalization was eventually obtained. Follow-up angiography on postoperative day 7 showed a dramatic improvement in venous outflow. The patient was transferred to a rehabilitation hospital on postoperative day 42. We describe our combined approach using aspiration, and Penumbra and balloon catheters, to achieve mechanical thrombectomy for sinus thrombosis.

Republished: Sinus thrombectomy for purulent cerebral venous sinus thrombosis utilizing a novel combination of the Trevo stent retriever and the Penumbra ACE aspiration catheter: the stent anchor with mobile aspiration technique

2015 ◽  
Vol 8 (6) ◽  
pp. e24-e24 ◽  
Author(s):  
Justin R Mascitelli ◽  
Margaret Pain ◽  
Hekmat K Zarzour ◽  
Peter Baxter ◽  
Saadi Ghatan ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Stent Retriever ◽  
Venous Sinus ◽  
Dramatic Improvement ◽  
Lower Extremity Weakness ◽  
Venous Sinus Thrombosis ◽  
Sagittal Sinus ◽  
Aspiration Technique ◽  
Intracranial Complications

Intracranial complications of sinusitis are rare but life threatening. We present a case of a 17-year-old woman with sinusitis who deteriorated over the course of 12 days from subdural empyema and global purulent cerebral venous sinus thrombosis. The patient was managed with surgery and mechanical thrombectomy utilizing a novel ‘stent anchor with mobile aspiration technique’, in which a Trevo stent retriever (Stryker) was anchored in the superior sagittal sinus (SSS) while a 5 MAX ACE reperfusion catheter (Penumbra) was passed back and forth from the SSS to the sigmoid sinus with resultant dramatic improvement in venous outflow. The patient was extubated on postoperative day 3 and was discharged with minimal lower extremity weakness on postoperative day 11. This is the first report using the Trevo stent retriever for sinus thrombosis. It is important to keep these rare complications in mind when evaluating patients with oral and facial infections.

Safety and Validity of Mechanical Thrombectomy and Thrombolysis on Severe Cerebral Venous Sinus Thrombosis

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Guangwen Li ◽  
Xianwei Zeng ◽  
Mohammed Hussain ◽  
Ran Meng ◽  
Yi Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Treatment Modality ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Magnetic Resonance Venography ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Digital Subtract Angiography

Abstract BACKGROUND: Although the majority of patients with cerebral venous sinus thrombosis (CVST) obtain an optimistic clinical outcome after heparin or warfarin treatment, there remains a subgroup of patients who do not respond to conventional anticoagulation treatment. These patients, especially younger people, as documented by hospital-based studies, have a high morbidity and mortality rate. OBJECTIVE: To verify the safety and efficacy of a dual mechanical thrombectomy with thrombolysis treatment modality option in patients with severe CVST. METHODS: Fifty-two patients diagnosed with CVST were enrolled and treated with mechanical thrombectomy combined with thrombolysis. Patients underwent urokinase 100 to 1500 × 103 IU intravenous sinus injection via a jugular catheter after confirming diagnoses of CVST by using either magnetic resonance imaging/magnetic resonance venography or digital subtract angiography. Information obtained on the patients included recanalization status of venous sinuses as evaluated by magnetic resonance venography or digital subtract angiography at admission, during operation, and at 3- and 6-month follow-up after treatment. RESULTS: The percentage of patients that showed complete and partial recanalization were 87% and 6%, respectively, after mechanical thrombectomy combined with thrombolysis treatment; 8% of the patients showed no recanalization. The modified Rankin Scale scores were 1.0 ± 0.9, 0.85 ± 0.63, and 0.37 ± 0.53 for discharge, and 3- and 6-month follow-up, respectively. A total of 6 patients died despite receiving aggressive treatment. No cases of relapse occurred after 3 to 6 months of follow-up. CONCLUSION: Thrombectomy combined with thrombolysis is a safe and valid treatment modality to use in severe CVST cases or in intractable patients that have shown no adequate response to antithrombotic drugs.

scholarly journals Successful mechanical thrombectomy in a comatose patient with cerebral venous sinus thrombosis: A case report

2017 ◽  
Vol 23 (4) ◽  
pp. 437-440 ◽  
Author(s):  
Merel JJ Verhagen ◽  
Adriaan CGM van Es ◽  
Geert J Lycklama à Nijeholt ◽  
Korné Jellema ◽  
Jonathan Coutinho ◽  
...  
Keyword(s):  
Case Report ◽  
Alternative Treatment ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Comatose Patient ◽  
Unfavourable Outcome ◽  
Treatment Methods ◽  
Venous Sinus Thrombosis

Cerebral venous sinus thrombosis is a rare cause of stroke, which is routinely treated with systemic heparin. Unfavourable outcome is often seen in severe cases. Therefore alternative treatment methods should be explored in these patients. Due to the risk of haemorrhagic complications, treatment without administration of thrombolytics is of particular interest. This report presents a case of successful mechanical thrombectomy, without the use of thrombolytics, in a comatose patient with cerebral venous sinus thrombosis.

scholarly journals First off Label Endovascular Clinical Experience to Treat Diffuse Cerebral Venous Sinus Thrombosis Using the INARI FlowTriever System: Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Saif Bushnaq ◽  
Samer Abdul Kareem ◽  
Nicholas Liaw ◽  
Bader Alenzi ◽  
Muhammad Khaleeq Ahmed ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Experience ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Safety And Efficacy ◽  
Venous Sinus Thrombosis ◽  
Off Label ◽  
Aggressive Interventions

Anticoagulation with heparin is the current mainstay treatment for Cerebral Venous Sinus Thrombosis (CVST). Endovascular treatment is increasingly being used to treat patients with CVST who are non-responsive to anticoagulation. These more aggressive interventions include catheter-based local chemical thrombolysis, balloon angioplasty and mechanical thrombectomy with uncertain safety and efficacy. Here we describe the first reported clinical experience using the INARI FlowTriever system to treat a patient presented with focal weakness and found to have diffuse CVST.

scholarly journals Cerebral Venous Sinus Thrombosis and Hydrocephalus in a Vegan Secondary to Acquired Hyperhomocystinaemia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
W. D. D. Priyankara ◽  
A.V. I. Chandimal ◽  
F. G. Sivagnanam ◽  
E. M. Manoj
Keyword(s):  
Sinus Thrombosis ◽  
External Ventricular Drain ◽  
Cerebral Venous Sinus Thrombosis ◽  
Acute Onset ◽  
Venous Sinus ◽  
Dramatic Improvement ◽  
Acute Hydrocephalus ◽  
Venous Sinus Thrombosis ◽  
Cerebrospinal Fluid Diversion ◽  
Neuropsychiatric Manifestations

Cerebral venous sinus thrombosis associated with acute hydrocephalus and periventricular leukoencephalopathy is a challenging combination, in a critically ill with deteriorating neurology. We report a case of a young man with acute onset neuropsychiatric manifestations, admitted to the intensive care unit. He was found to have widespread cerebral venous sinus thrombosis, hyperintensities in basal ganglia, and acute hydrocephalus in magnetic resonance imaging, necessitating cerebrospinal fluid diversion, by way of an external ventricular drain and therapeutic anticoagulation. He had otherwise normal routine biochemistry, except for macrocytosis, which prompted us to suspect acquired hyperhomocysteinemia secondary to cobalamin and folate deficiency, in the background of him being a vegan. Replacement of vitamin B12, folic acid, pyridoxine along with anticoagulation and control of intracranial pressure with external ventricular drain lead to dramatic improvement of his neurology. Therefore, high index of suspicion is crucial for a better outcome in otherwise irreversible neurological damage in acquired hyperhomocystinaemia.

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