Borhani Haghighi Afshin, Mahmoodi Mojtaba, Edgell Randall C, Cruz-Flores Salvador, Ghanaati Hosein, Jamshidi Mohammad, Zaidat Osama O
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Clin Appl Thromb Hemost. 2014 Jul;20(5):507-15. doi: 10.1177/1076029612470968. Epub 2013 Jan 7.
Endovascular treatment of cerebral venous sinus thrombosis (CVST) includes pharmacological and mechanical thrombolysis.
The authors searched the English literature on CVST from 1990 to 2012 for all case reports or case series of mechanical thrombectomy.
A total of 64 patients were treated in all published studies. The techniques for mechanical thrombectomy included rheolytic thrombectomy with an AngioJet device (46.9%), clot retraction with the Penumbra system (4.7%), clot retraction with a Fogarty catheter (1.6%), clot retraction with a microsnare (3.1%), balloon venoplasty without stenting (18.7%), balloon venoplasty with stenting (4.7%), and an amalgam of techniques (18.7%). Nine (16.1%) patients died. At the most recent follow-up, 40 (62.5%) patients had no disability or minor disability and 7 (10.9%) patients had major disability.
Randomized multiinstitutional clinical trials with larger number of participants are needed to sufficiently compare the effect of intrasinus thrombolysis and mechanical thrombectomy to standard-of-care anticoagulation therapy.
脑静脉窦血栓形成（CVST）的血管内治疗包括药物溶栓和机械溶栓。
作者检索了1990年至2012年关于CVST的英文文献，查找所有机械取栓的病例报告或病例系列。
所有已发表研究共治疗了64例患者。机械取栓技术包括使用AngioJet装置进行流变溶栓（46.9%）、使用Penumbra系统进行血栓回缩（4.7%）、使用Fogarty导管进行血栓回缩（1.6%）、使用微型圈套器进行血栓回缩（3.1%）、不置入支架的球囊血管成形术（18.7%）、置入支架的球囊血管成形术（4.7%）以及多种技术联合使用（18.7%）。9例（16.1%）患者死亡。在最近一次随访时，40例（62.5%）患者无残疾或轻度残疾，7例（10.9%）患者有重度残疾。
需要开展有更多参与者的多机构随机临床试验，以充分比较窦内溶栓和机械取栓与标准抗凝治疗的效果。
