Endovascular treatment for cerebral venous sinus thrombosis - a single center study
| Autor: | Marie Elisabeth Cortsen, J. Højgaard, Mats Cronqvist, Jakob Stensballe, Trine Stavngaard, Markus Holtmannspötter, Karen Lise Welling, Klaus Hansen, Henrik Gutte, Thomas Andersen, Thomas Truelsen |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Cranial Sinuses Single Center Endovascular therapy 03 medical and health sciences Sinus Thrombosis Intracranial Young Adult 0302 clinical medicine Medicine Humans Thrombolytic Therapy Endovascular treatment Cerebral venous sinus thrombosis Aged Retrospective Studies Thrombectomy business.industry Endovascular Procedures Cerebrovascular disorder General Medicine Middle Aged medicine.disease Surgery Treatment Outcome 030220 oncology & carcinogenesis Systemic anticoagulation Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | British journal of neurosurgery. 35(3) |
| ISSN: | 1360-046X |
| Popis: | Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disorder. The majority of these patients respond favorably to systemic anticoagulation. However, a subset of patients will deteriorate clinically, despite optimal medical therapy.Retrospective single center study of 28 consecutive CVST patients treated with systemic anticoagulation and additional endovascular therapy.Median age was 37.5 years (range 15-76 years), there were 21 (75%) women, and 20 (71%) had thrombosis involving ≥2 venous sinuses. Intracranial hemorrhage (ICH) was present at admission in 18 patients (64%). Endovascular therapy consisted of local thrombolysis in 26 (93%) patients; 9 patients (32%) had additional mechanical thrombectomy, and in 2 (7%) patients thrombectomy alone was performed. Complete recanalization at end of the final intervention was achieved in 15 patients (54%), partial recanalization in 11 patients (39%), whereas there was no recanalization in 2 patients (7%). On follow-up imaging, conducted between 3 and 6 months, recanalization further improved to 76%, 19% and 5%, respectively. A favorable outcome (mRS ≤ 2) was achieved in 63% of patients at 3 months, which improved to 79% at 6 months. Post-procedural ICH or volume expansion of preexisting ICH was seen in 9 patients (32%). In total 5 patients died (18%).Systemic anticoagulation with the addition of endovascular therapy with local thrombolysis and/or mechanical thrombectomy is a potential strategy to obtain recanalization in patients with CVST who deteriorate clinically despite medical therapy or are comatose. Endovascular therapy may increase the risk of ICH. |
| Databáze: | OpenAIRE |
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