Stenting of symptomatic lateral sinus thrombosis refractory to mechanical thrombectomy.

Autor:	Lu G; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Shin JH; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea., Song Y; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea., Lee DH; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
Jazyk:	angličtina
Zdroj:	Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2019 Dec; Vol. 25 (6), pp. 714-720. Date of Electronic Publication: 2019 May 27.
DOI:	10.1177/1591019919852168
Abstrakt:	Objective: Endovascular mechanical thrombectomy for the treatment of cerebral venous sinus thrombosis is not always successful. We present our experience of using self-expanding stents to facilitate effective recanalization of persistent lateral sinus thrombosis refractory to endovascular mechanical thrombectomy. Methods: Data from patients who underwent endovascular mechanical thrombectomy for the treatment of acute symptomatic cerebral venous sinus thrombosis between August 2015 and July 2018 were evaluated. Patient demographics, procedural techniques, devices used and follow-up outcomes were assessed. Results: A total of 14 patients underwent endovascular mechanical thrombectomy during the study period. Of these, stenting of the occluded sinus was performed in five patients with extensive sinus thrombosis after conventional endovascular mechanical thrombectomy. Three of the five patients had a variable degree of venous infarction and/or hemorrhage before treatment. The target lesion was located in the right lateral sinus in all five patients. Due to the length of the involved sinus, two stents were required in one patient and three stents in two patients. The only procedure-related complication was an asymptomatic tearing of the sinus wall in one patient. Stent patency could not be maintained in two patients due to stent buckling within the jugular foramen segment and an inability to maintain antiplatelet medication. Modified Rankin Scale scores at 2-16 months were zero in two patients, one in two patients, and five in one patient. Conclusions: Stenting for the thrombotic occlusion of the lateral sinus is a feasible rescue method to overcome unsuccessful endovascular mechanical thrombectomy. However, currently available stenting systems may be unsuitable for use in the intracranial dural sinus system.
Databáze:	MEDLINE
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