Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
J Neurointerv Surg. 2014 Jun;6(5):e32. doi: 10.1136/neurintsurg-2013-010866.rep. Epub 2013 Sep 18.
We present a young woman with rapidly progressive neurologic decline in the setting of malignant cerebral edema due to extensive superior sagittal sinus thrombosis and cortical venous thrombosis despite intravenous heparin administration. Complete revascularization of the occluded sinus was achieved using suction thrombectomy with the 5 max Penumbra catheter in combination with the Solitaire FR clot retrieval device. The successful endovascular treatment halted the progression of her cerebral edema, and the patient eventually had an excellent recovery after prolonged intensive medical therapy. To our knowledge, this is the first reported case describing such a combined mechanical approach for cerebral venous sinus thrombosis. The clot retrieval properties of the Solitaire device combined with direct aspiration via the newest generation Penumbra catheters may allow more rapid, safe and efficient revascularization than all previously reported endovascular treatments for this potentially devastating condition.
我们介绍了一位年轻女性，她因广泛的上矢状窦血栓形成和皮质静脉血栓形成导致恶性脑水肿，出现进行性神经功能恶化，尽管给予了静脉肝素治疗。使用 5 Max Penumbra 抽吸血栓切除术联合 Solitaire FR 血栓取出装置成功实现了闭塞窦的再通。成功的血管内治疗阻止了她的脑水肿进展，经过长时间的强化药物治疗，患者最终恢复良好。据我们所知，这是首例描述这种联合机械方法治疗脑静脉窦血栓形成的病例。Solitaire 装置的血栓取出特性与通过最新一代 Penumbra 导管直接抽吸相结合，可能比之前所有报道的这种潜在破坏性疾病的血管内治疗方法更快、更安全、更有效。
