Endovascular treatment for cerebral venous thrombosis: current status, challenges, and opportunities

2022 ◽  
pp. neurintsurg-2021-018101
Author(s):  
Mayank Goyal ◽  
Joachim Fladt ◽  
J M Coutinho ◽  
Rosalie McDonough ◽  
Johanna Ospel
Keyword(s):  
Prognostic Factors ◽  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Cerebral Venous Thrombosis ◽  
Current Status ◽  
Technical Success ◽  
Course Of Disease ◽  
Rescue Treatment ◽  
Challenges And Opportunities ◽  
Near Future

Cerebral venous thrombosis (CVT) mostly affects young people. So far, endovascular treatment (EVT) has not been shown to be beneficial in CVT, partially because venous EVT tools are not yet fully optimized, and therefore EVT is only used as a rescue treatment in rare cases. Identifying a subgroup of CVT patients that could benefit from EVT is challenging, given the milder course of disease compared with acute ischemic stroke, the paucity of data on prognostic factors (both in the clinical and imaging domain), and the lack of consensus on what constitutes 'technical success' in CVT EVT. In this review, we discuss the major obstacles that are encountered when trying to identify CVT patients that may benefit from EVT, and propose a roadmap that could help to overcome these challenges in the near future.

Abstract WP2: Trends of Endovascular Treatment in Cerebral Venous Thrombosis: Estimations From Nationwide Inpatient Sample

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Fazeel M Siddiqui ◽  
Matthew Weber ◽  
Sudeepta Dandapat ◽  
Nazan Aksan ◽  
Steve Scaife ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Cerebral Venous Thrombosis ◽  
Nationwide Inpatient Sample

scholarly journals Epidemiology, Endovascular Treatment, and Prognosis of Cerebral Venous Thrombosis: US Center Study of 152 Patients

2017 ◽  
Vol 6 (6) ◽  
Author(s):  
Kristin Salottolo ◽  
Jeffrey Wagner ◽  
Donald F. Frei ◽  
David Loy ◽  
Richard J. Bellon ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Cerebral Venous Thrombosis ◽  
Center Study

Endovascular treatment of cerebral venous thrombosis.

2021 ◽  
Vol 26 (5) ◽  
pp. 24-29
Author(s):  
A. A. Kulesh ◽  
A. O. Karakulov
Keyword(s):  
Blood Flow ◽  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Cerebral Venous Thrombosis ◽  
Clinical Case ◽  
Lymphoblastic Leukemia ◽  
Prolonged Administration ◽  
Local Thrombolysis ◽  
Cerebral Sinus ◽  
Transverse Sinuses

The article describes a clinical case of cerebral venous thrombosis involving the deep venous system in a 42-year-old patient suffering from acute lymphoblastic leukemia. As the patient’s condition progressively deteriorated despite anticoagulant therapy, endovascular treatment was attempted. Transvenous thrombectomy and local thrombolysis were performed, which made it possible to achieve only partial recanalization. Further prolonged administration of alteplase into the cerebral sinus through a microcatheter facilitated complete recanalization of the direct and transverse sinuses. The restoration of blood flow was accompanied by regression of neurological deficit. This case is discussed in the context of modern approaches to endovascular treatment of cerebral venous thrombosis.

Abstract WP10: Prolonged Microcatheter-based Local Thrombolytic Infusion as a Salvage Treatment for Failed Endovascular Treatment for Cerebral Venous Thrombosis: A Multicenter Registry

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Mikayel Grigoryan ◽  
Gaurav K Guliani ◽  
Muhammad A Saleem ◽  
Emrah Aytac ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Cerebral Venous Thrombosis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Response To Treatment ◽  
Tissue Plasminogen ◽  
Final Response ◽  
Assess Treatment Response ◽  
Multicenter Registry

Background: Transvenous endovascular treatment including combination pharmacological and mechanical modalities is reserved for patients with cerebral venous thrombosis (CVT) not responsive to standard anticoagulation. However, transvenous endovascular treatment may not always be successful in achieving recanalization. Objective: To determine the effectiveness of prolonged microcatheter based local thrombolytic infusion in treatment of patients with CVT who achieved no or suboptimal recanalization with endovascular treatment. Methods: Patients who underwent transvenous endovascular treatment for cerebral venous thrombosis at three hospitals were identified through local registries. The final response to treatment was assessed and prolonged microcatheter based local thrombolytic infusion was instituted in selected patients as second line treatment. Serial angiograms were performed to assess treatment response and determine the duration of infusion. Results: Of the 85 patients admitted with CVT, 13 patients underwent 14 transvenous endovascular treatments. Initial treatment was considered suboptimal in 10/14 procedures due to no recanalization in 6, partial recanalization in 3, and re-occlusion in 1 patient. A prolonged microcatheter-based local recombinant tissue plasminogen activator (rt-PA) infusion was used in 9 of the 10 procedures for a median duration of 16 hours (range 15-22 hours). Follow up angiography demonstrated complete recanalization in 4 procedures and improvement of the partial recanalization in 5 additional procedures. One patient died before the follow up imaging could be acquired. None of the patients developed intracranial hemorrhage associated with local thrombolytic infusion. The microcatheter position had shifted during the infusion in one procedure. Conclusion: Prolonged microcatheter based local thrombolytic infusion appears to effective treatment in patients who have suboptimal response to acute transvenous endovascular treatment without any additional adverse events.

scholarly journals Revitalizing Irrigation Systems for Reducing Effects of Climate Change on Irrigated Agriculture in Nepal

2012 ◽  
pp. 106-111 ◽  
Author(s):  
Mahesh Man Shrestha
Keyword(s):  
Climate Change ◽  
Current Status ◽  
Irrigated Agriculture ◽  
Irrigation Systems ◽  
Adaptation Measures ◽  
Mitigation And Adaptation ◽  
Policy And Strategy ◽  
Irrigation Policy ◽  
Challenges And Opportunities ◽  
Near Future

Effects of Climate Change (CC) on hydrology and irrigated agriculture in Nepalese irrigation systems will be one of the major constraints in near future in irrigation development. The current status of Nepalese irrigation systems is highlighted briefly with its problems, constraints, challenges and opportunities, and current public policies and regulations in irrigation are summarized briefly with their relevancy and constraints. Reviewing the Agricultural Perspectives Plan (APP) and other policy and strategy frameworks, analyzing its performance and the relevance of its priorities and strategies to the current situation, and based on above facts mitigation and adaptation measures are suggested for short, medium and long-term strategies to revitalize irrigation systems of Nepal for irrigated agriculture enhancement. Suggestions and recommendations to incorporate are made in formulating its principle strategy into a forthcoming Irrigation Policy framework.DOI: http://dx.doi.org/10.3126/hn.v11i1.7225 Hydro Nepal Special Issue: Conference Proceedings 2012 pp.106-111

scholarly journals Endovascular treatment of dural arteriovenous fistula after cerebral venous thrombosis in a child

2018 ◽  
Author(s):  
Luana Gatto ◽  
Luis Sousa ◽  
Thiago Simões ◽  
Guilherme Alves ◽  
Tayna Miranda ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Cerebral Venous Thrombosis ◽  
Dural Arteriovenous Fistula

scholarly journals Effect of Endovascular Treatment With Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis

2020 ◽  
Vol 77 (8) ◽  
pp. 966 ◽  
Author(s):  
Jonathan M. Coutinho ◽  
Susanna M. Zuurbier ◽  
Marie-Germaine Bousser ◽  
Xunming Ji ◽  
Patricia Canhão ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Medical Management ◽  
Cerebral Venous Thrombosis ◽  
Standard Care
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