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Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis
BACKGROUND: In dural venous sinus thrombosis (DVST), the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascu...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385784/ https://www.ncbi.nlm.nih.gov/pubmed/28515593 http://dx.doi.org/10.4103/0971-3026.202956 |
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author | Mammen, Suraj Keshava, Shyamkumar Nidugala Moses, Vinu Aaron, Sanjith Ahmed, Munawwar Chiramel, George K Mani, Sunithi E Alexander, Mathew |
author_facet | Mammen, Suraj Keshava, Shyamkumar Nidugala Moses, Vinu Aaron, Sanjith Ahmed, Munawwar Chiramel, George K Mani, Sunithi E Alexander, Mathew |
author_sort | Mammen, Suraj |
collection | PubMed |
description | BACKGROUND: In dural venous sinus thrombosis (DVST), the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. MATERIALS AND METHODS: Eight patients with magnetic resonance imaging (MRI)-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System(®). In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. RESULTS: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS), with 5/8 (62%) patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months), and there were no new neurological events during the follow-up period. CONCLUSION: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up. |
format | Online Article Text |
id | pubmed-5385784 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-53857842017-05-17 Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis Mammen, Suraj Keshava, Shyamkumar Nidugala Moses, Vinu Aaron, Sanjith Ahmed, Munawwar Chiramel, George K Mani, Sunithi E Alexander, Mathew Indian J Radiol Imaging Interventional Radiology BACKGROUND: In dural venous sinus thrombosis (DVST), the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. MATERIALS AND METHODS: Eight patients with magnetic resonance imaging (MRI)-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System(®). In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. RESULTS: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS), with 5/8 (62%) patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months), and there were no new neurological events during the follow-up period. CONCLUSION: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5385784/ /pubmed/28515593 http://dx.doi.org/10.4103/0971-3026.202956 Text en Copyright: © 2017 Indian Journal of Radiology and Imaging http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Interventional Radiology Mammen, Suraj Keshava, Shyamkumar Nidugala Moses, Vinu Aaron, Sanjith Ahmed, Munawwar Chiramel, George K Mani, Sunithi E Alexander, Mathew Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title | Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title_full | Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title_fullStr | Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title_full_unstemmed | Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title_short | Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
title_sort | role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis |
topic | Interventional Radiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385784/ https://www.ncbi.nlm.nih.gov/pubmed/28515593 http://dx.doi.org/10.4103/0971-3026.202956 |
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