Endovascular treatment of cerebral venous thrombosis: Contemporary multicenter experience

Interv Neuroradiol. 2015 Aug;21(4):520-6. doi: 10.1177/1591019915583015. Epub 2015 Jun 8.

Abstract

Endovascular therapy of cerebral venous thrombosis using modern approaches to intracranial recanalization, such as stent retrievers and aspiration thrombectomy, is not well described. We performed a retrospective review of data for consecutive patients with venous sinus thrombosis who underwent endovascular treatment between 1 January 2010 and 31 December 2013 at participating institutions. We identified a total of 13 patients with a diagnosis of cerebral venous thrombosis. The most frequently utilized type of endovascular intervention was the Penumbra aspiration system (Penumbra Inc., Alameda, California, USA) (nine cases), followed by local infusion of tissue plasminogen activator (bolus and/or drip in six cases) and stent retrievers (Solitaire FR (Covidien, Irvine, California, USA) in three cases and Trevo (Stryker, Kalamazoo, Michigan, USA) in one case). Overall, multimodality treatment (two or more different types of devices or approaches) was performed in 62% of cases. Follow-up data were available for 11 patients; of those, five had a favorable clinical outcome (defined as modified Rankin Scale score of 0-2) and three patients died. Various endovascular approaches are utilized in current clinical practice. A multimodal approach to endovascular therapy for the treatment of cerebral venous thrombosis resulted in partial or complete restoration of flow in all cases, yet the mortality rate of 27% indicates the need for improvement in recanalization strategies for this disorder.

Keywords: Aspiration thrombectomy catheter; cerebral venous thrombosis; endovascular therapy; stent retriever.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticoagulants / therapeutic use
  • Cerebral Angiography
  • Combined Modality Therapy
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / mortality
  • Sinus Thrombosis, Intracranial / surgery*
  • Stents
  • Suction
  • Thrombectomy
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Anticoagulants
  • Tissue Plasminogen Activator