Cargando…

Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report

The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venog...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Chengwei, Wang, Qiujing, Li, Xifeng, Lu, Ziming, He, Jian, Fang, Qinrui, Ke, Xunchang, Duan, Chuanzhi, Li, Tielin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647711/
https://www.ncbi.nlm.nih.gov/pubmed/29067093
http://dx.doi.org/10.3892/etm.2017.5043
_version_ 1783272290805350400
author Chen, Chengwei
Wang, Qiujing
Li, Xifeng
Lu, Ziming
He, Jian
Fang, Qinrui
Ke, Xunchang
Duan, Chuanzhi
Li, Tielin
author_facet Chen, Chengwei
Wang, Qiujing
Li, Xifeng
Lu, Ziming
He, Jian
Fang, Qinrui
Ke, Xunchang
Duan, Chuanzhi
Li, Tielin
author_sort Chen, Chengwei
collection PubMed
description The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy. Stent-assisted angioplasty was also performed when patients presented with venous sinus stenosis. A total of 15 patients in group B received systemic anticoagulant treatment. Subsequently, warfarin was administered orally for 3 to 12 months as a continuous anticoagulant therapy. International normalized ratio was monitored when patients were receiving anticoagulant therapy. Additionally, clinical presentation, decision to escalate therapy, recanalization, Glasgow Coma Scale, modified Rankin Scale (mRS) and the clinical outcome was assessed. A total of 14 patients (9 female patients, 5 male patients), with ages ranging from 17 to 57 years, met the criteria of endovascular therapy. The clinical symptoms of 12 patients had improved after receiving endovascular therapy and only 2 patients suffered from intracranial hemorrhage following the procedure. Complete recanalization of venous sinus was exhibited in 10/14 (71.4%) patients in group A when compared with 1/15 (6.7%) patients in group B. mRS were improved in the 12-month follow-up in groups A and B when compared with that at admission. In the present study, patients with acute CVST treated with stent retriever thrombectomy combined with local thrombolytic therapy had a favorable outcome. To conclude, the present study provides a treatment option in treating CVST, particularly for patients that present with evident cortical venous outflow stasis or deteriorate neurology, despite appropriate anticoagulant therapy.
format Online
Article
Text
id pubmed-5647711
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher D.A. Spandidos
record_format MEDLINE/PubMed
spelling pubmed-56477112017-10-24 Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report Chen, Chengwei Wang, Qiujing Li, Xifeng Lu, Ziming He, Jian Fang, Qinrui Ke, Xunchang Duan, Chuanzhi Li, Tielin Exp Ther Med Articles The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy. Stent-assisted angioplasty was also performed when patients presented with venous sinus stenosis. A total of 15 patients in group B received systemic anticoagulant treatment. Subsequently, warfarin was administered orally for 3 to 12 months as a continuous anticoagulant therapy. International normalized ratio was monitored when patients were receiving anticoagulant therapy. Additionally, clinical presentation, decision to escalate therapy, recanalization, Glasgow Coma Scale, modified Rankin Scale (mRS) and the clinical outcome was assessed. A total of 14 patients (9 female patients, 5 male patients), with ages ranging from 17 to 57 years, met the criteria of endovascular therapy. The clinical symptoms of 12 patients had improved after receiving endovascular therapy and only 2 patients suffered from intracranial hemorrhage following the procedure. Complete recanalization of venous sinus was exhibited in 10/14 (71.4%) patients in group A when compared with 1/15 (6.7%) patients in group B. mRS were improved in the 12-month follow-up in groups A and B when compared with that at admission. In the present study, patients with acute CVST treated with stent retriever thrombectomy combined with local thrombolytic therapy had a favorable outcome. To conclude, the present study provides a treatment option in treating CVST, particularly for patients that present with evident cortical venous outflow stasis or deteriorate neurology, despite appropriate anticoagulant therapy. D.A. Spandidos 2017-11 2017-08-28 /pmc/articles/PMC5647711/ /pubmed/29067093 http://dx.doi.org/10.3892/etm.2017.5043 Text en Copyright: © Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Articles
Chen, Chengwei
Wang, Qiujing
Li, Xifeng
Lu, Ziming
He, Jian
Fang, Qinrui
Ke, Xunchang
Duan, Chuanzhi
Li, Tielin
Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title_full Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title_fullStr Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title_full_unstemmed Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title_short Stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: A case report
title_sort stent retriever thrombectomy combined with local thrombolytic therapy for cerebral venous sinus thrombosis: a case report
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647711/
https://www.ncbi.nlm.nih.gov/pubmed/29067093
http://dx.doi.org/10.3892/etm.2017.5043
work_keys_str_mv AT chenchengwei stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT wangqiujing stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT lixifeng stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT luziming stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT hejian stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT fangqinrui stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT kexunchang stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT duanchuanzhi stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport
AT litielin stentretrieverthrombectomycombinedwithlocalthrombolytictherapyforcerebralvenoussinusthrombosisacasereport