Current endovascular strategies for cerebral venous thrombosis: report of the SNIS Standards and Guidelines Committee

Lee, Seon Kyu; Mokin, Maxim; Hetts, Steven W.; Fifi, Johanna T; Bousser, Marie Germaine; Fraser, Justin F.

doi:10.1136/neurintsurg-2018-013973

Cited by 90 publications

(109 citation statements)

References 85 publications

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“…MRI had a 100% diagnostic value in our study, whereas CT scan missed one patient. A review by Lee et al (20) showed that CT scan was not specific. The transverse and sigmoid sinuses were presented as the most common site of thrombosis in a cross-sectional study by Coutinho et al…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Thrombosis in Pregnancy

Ala¹,

Hojjatpanah²,

Vahdati³

et al. 2019

Istanbul Med J

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Amaç: Sık görülen bir hastalık olmasa da, serebral venöz tromboz (SVT) nispeten morbid olarak kabul edilmiştir. İran'da SVT hakkında çok az araştırma vardır, ancak hamilelik ve lohusalıkta daha olasıdır. Bu nedenle gebelikte insidans ve risk faktörlerini belirlemek için bu çalışmayı yaptık. Yöntemler: Yirmi sekiz olgu hastane arşivinden seçildi. Nisan 2015-Mart 2018 tarihleri arasında hastaneye başvuran ve SVT tanısı almış gebelerin dosyaları demografik ve gebelik bilgileri açısından incelendi. İstatistiksel yöntemler ve yazılım kullanıldı. Conclusion: The study reveals some risk factors for CVT, such as immobilization, chronic hypertension, preeclampsia and caesarean section.

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Section: Discussionmentioning

confidence: 99%

Cerebral Venous Thrombosis in Pregnancy

Ala¹,

Hojjatpanah²,

Vahdati³

et al. 2019

Istanbul Med J

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“…Endovascular interventions have been employed to this end [7, 9, 13]. Methods include both mechanical thrombectomy with stent retriever devices and catheter infusion of thrombolytic agents.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Surgical Superior Sagittal Sinus Thrombectomy in Refractory Thrombosis: A Technical Note

et al. 2019

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Objective: Surgical treatment options are limited for medically and endovascular refractory cerebral venous sinus thrombosis (CVT). We describe the technical feasibility of open, direct sinus thrombectomy in a pediatric patient with medically and endovascular refractory CVT. Methods: A 15-year-old patient with superior sagittal sinus (SSS) thrombosis refractory to medical and endovascular treatment experienced clinical deterioration with the progression of bifrontal hematomas and cerebral edema. The patient was treated surgically with a decompressive hemicraniectomy and burr hole SSS thrombectomy with a Fogarty balloon and direct sinus injection of tissue plasminogen activator. Results: Surgical treatment with decompressive craniotomy and direct sinus thrombectomy was technically feasible with excellent intracranial pressure control, and radiological recanalization of the superior sagittal sinus with a good clinical outcome. Conclusion: Direct surgical sinus thrombectomy is a potential concomitant treatment strategy with decompressive craniectomy for medically refractory CVT in a pediatric setting.

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“…[ 2 ] The estimated incidence of CVST is 1.3/100,000 person-years in the general population, 2.8 per 100,000 person-years in women ages 31–50 years, and 0.7 per 100,000 in children younger than 18 years. [ 7 ] CVST carries an approximate mortality rate of 6–10%. [ 9 ] Associated risk factors are vast, and some of the most common are inherited prothrombotic disorders (i.e., methylenetetrahydrofolate reductase mutations, protein C and S deficiencies, and factor V Leiden deficiency), pregnancy, and oral contraceptive use.…”

Section: Introductionmentioning

confidence: 99%

“…[ 9 ] Associated risk factors are vast, and some of the most common are inherited prothrombotic disorders (i.e., methylenetetrahydrofolate reductase mutations, protein C and S deficiencies, and factor V Leiden deficiency), pregnancy, and oral contraceptive use. [ 1 , 7 ] Approximately 15% of patients with CVST do not have identifiable risk factors. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

“…published an algorithm that effectively outlines the diagnosis and management of suspected CVST. [ 7 ] After the diagnosis has been confirmed, treatment is initiated systemically with either unfractionated heparin (UFH) or low-molecular-weight heparin, even in patients with hemorrhage. In patients who do not respond appropriately or continue to decline despite systemic anticoagulation, surgical and neurointerventional procedures such as decompressive craniectomy, intrasinus thrombolysis, and/or mechanical thrombectomy become options.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mechanical venous thrombectomy and prolonged infusion of tissue plasminogen activator for cerebral venous sinus thrombosis: Video case report

Housley

Vakharia

Waqas

et al. 2020

Surgical Neurology International

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Background: Cerebral venous sinus thrombosis (CVST) is a rare and often misdiagnosed condition with mortality rates ranging from 6 to 10%. Diagnosis and monitoring are typically achieved through noninvasive imaging, including computed tomography or magnetic resonance venography. The current standard of treatment is systemic anticoagulation. However, in patients who continue to decline neurologically or do not show sufficient response to or have absolute contraindications to systemic anticoagulation, endovascular treatments are an alternative. Endovascular options are poorly studied and specific devices have not been developed, partially due to the rare nature of the disease. Here, we present a case report detailing the treatment of extensive CVST from the vein of Galen to the sigmoid sinus using mechanical thrombectomy and local infusions of unfractionated heparin (UFH) and tissue plasminogen activator. Case Description: A 53-year-old man presented and was found to have extensive CVST extending from the vein of Galen to the left sigmoid sinus. Systemic UFH was begun; however, his condition continued to decline, and he was taken for endovascular intervention, wherein mechanical thrombectomy was undertaken using combinations of stent retrievers and balloon catheters, which provided acceptable revascularization. Unfortunately, his hospital course was further complicated by a cerebellar hematoma that was surgically evacuated and reocclusion of the sinus for which a microcatheter was placed for infusion of UFH and tissue plasminogen activator. Conclusion: Complicated CVST may require aggressive endovascular management. Local infusions of heparin and thrombolytic agents as well as mechanical thrombectomy are safe alternative options.

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Current endovascular strategies for cerebral venous thrombosis: report of the SNIS Standards and Guidelines Committee

Cited by 90 publications

References 85 publications

Cerebral Venous Thrombosis in Pregnancy

Cerebral Venous Thrombosis in Pregnancy

Surgical Superior Sagittal Sinus Thrombectomy in Refractory Thrombosis: A Technical Note

Mechanical venous thrombectomy and prolonged infusion of tissue plasminogen activator for cerebral venous sinus thrombosis: Video case report

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