Article Text

PDF
Mechanical thrombectomy with the penumbra system for treatment of venous sinus thrombosis
  1. Armen Choulakian,
  2. Michael J Alexander
  1. Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
  1. Correspondence to Professor Michael J Alexander, Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 W. Third St., Suite 800E, Los Angeles, CA 90048, USA

Abstract

Objective Venous sinus thrombosis can be a fatal condition. When systemic anticoagulation therapy fails or is high risk, endovascular chemical thrombolysis or mechanical thrombectomy may be necessary. We report our experience using the Penumbra system (PS; Penumbra, Alameda, California, USA) in a series of four patients with venous sinus thrombosis.

Methods Four patients were treated with mechanical thrombectomy using the PS for venous sinus thrombosis. Three of these patients also underwent balloon angioplasty following the PS device. Utility of this technique was evaluated by procedural success, improvement in neurological condition, avoidance of complications and follow-up imaging.

Results Technical success was achieved in all four patients with restoration of flow in the occluded sinuses without the use of chemical thrombolysis. No complications were encountered during the procedure and no postprocedural complications were attributable to the thrombectomy. One patient with glioblastoma died 6 weeks after the procedure. No new intracerebral hemorrhages were caused and there was no exacerbation of pretreatment intracerebral hemorrhages. Follow-up imaging was available in all but one patient to documented continued sinus patency. Neurologic improvement was seen in all patients after thrombectomy. Two patients have returned for outpatient follow-up and both are doing well.

Conclusion Endovascular treatment for venous sinus thrombosis with the PS is a safe and efficacious alternative to the other forms of mechanical thrombectomy reported in the literature. Good clinical and radiographic results can be obtained without the need for chemical thrombolysis.

Statistics from Altmetric.com

Footnotes

  • Competing interests MJA is an institutional principal investigator in the PICS (Penumbra Imaging Collaborative Study) registry.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.