Endovascular treatment of acute thrombosis of cerebral veins and sinuses

Neuroradiol J. 2014 Sep;27(4):471-8. doi: 10.15274/NRJ-2014-10066. Epub 2014 Aug 29.

Abstract

Acute thrombosis of cerebral veins and sinuses (ATCVS) is a multifactorial disease with grave consequences. Because of its rare occurrence there are no proven treatment guidelines. Sixteen patients with ATCVS were treated. The final diagnosis was confirmed by digital subtraction angiography. Sinus catheterization was performed via transfemoral venous access. Treatment included mechanical manipulation of thrombi and thrombolytic therapy. A regression of clinical symptoms with a concomitant decrease of intracranial hypertension was achieved in all patients. Long-term results were studied in eight patients: none presented clinical signs of intracranial hypertension. Endovascular transvenous recanalization is an effective treatment for acute thrombosis of cerebral veins and sinuses. Along with the local thrombolysis, significant potential in the treatment of this complex pathology lies in the transvenous endovascular techniques of mechanical thrombus extraction, especially in patients with intracranial hemorrhage for whom the use of thrombolytic agents is restricted.

Keywords: endovascular procedures; sinus thrombosis; thrombolysis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / surgery*
  • Endovascular Procedures / methods*
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / therapy
  • Male
  • Mechanical Thrombolysis / methods*
  • Middle Aged
  • Recombinant Proteins / therapeutic use
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial / complications
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / therapy*
  • Thrombolytic Therapy / methods*
  • Tissue Plasminogen Activator / therapeutic use
  • Urokinase-Type Plasminogen Activator / therapeutic use
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / therapy*
  • Young Adult

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
  • saruplase