Article Text

Download PDFPDF
Case report
Republished: A novel combined approach using a Penumbra catheter and balloon catheter for cerebral venous sinus thrombosis
  1. Yoshikazu Matsuda1,2,
  2. Yoshihiro Owai1,
  3. Koji Kakishita1,
  4. Naoyuki Nakao2
  1. 1 Department of Neurosurgery, Hashimoto Municipal Hospital, Hashimoto, Wakayama, Japan
  2. 2 Wakayama Medical University School of Medicine Graduate School of Medicine, Department of Neurological Surgery, Wakayama, Japan
  1. Correspondence to Dr Yoshikazu Matsuda, Department of Neurosurgery, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan ; ymatsuda0517{at}


Cerebral venous sinus thrombosis is sometimes fatal. We describe a case of sinus thrombosis in a 43-year-old woman presenting with generalized seizure, delirium, and a 2 week history of headache and nausea. The patient underwent mechanical thrombectomy using a novel combined approach, in which a Shouryu HR balloon catheter (Kaneka) was anchored in the right transverse sinus (TS), sigmoid sinus (SS), and superior sagittal sinus (SSS), while a Penumbra 5 MAX ACE (Penumbra) catheter was moved back and forth between the right TS, SS, and SSS. Additionally, back and forth movement of the inflated balloon with aspiration—the so-called ‘dental floss technique’—was performed. Partial recanalization was eventually obtained. Follow-up angiography on postoperative day 7 showed a dramatic improvement in venous outflow. The patient was transferred to a rehabilitation hospital on postoperative day 42. We describe our combined approach using aspiration, and Penumbra and balloon catheters, to achieve mechanical thrombectomy for sinus thrombosis.

  • stroke
  • technique
  • balloon
  • catheter
  • infection

Statistics from

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.


  • Contributors YM performed the intervention in this patient and made a draft for this article. All authors reviewed this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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