Styczen Hanna, Tsogkas Ioannis, Liman Jan, Maus Volker, Psychogios Marios Nikos
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany.
World Neurosurg. 2019 Jul;127:e1097-e1103. doi: 10.1016/j.wneu.2019.04.049. Epub 2019 Apr 10.
Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT.
Endovascular procedures were performed in 13 patients with CVT in addition to standard anticoagulation therapy between 2011 and 2018. Clinical and radiologic parameters, procedure details, and angiographic and clinical outcomes were reviewed retrospectively.
In total, 14 thrombectomy procedures were executed. Successful recanalization of the occluded sinus was achieved in 86% of cases (12/14); of those, 29% were recanalized completely. Procedural complications included perforation of the transverse sinus in 1 case (7%). Worsening of intracranial hemorrhage occurred in 14% (2/14) of cases. Favorable clinical outcome (modified Rankin Scale score 0-2) was achieved in 12 of 13 patients (92%).
Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.
脑静脉血栓形成（CVT）是一种罕见疾病，可能导致致命后果。仅对标准药物治疗无反应的患者可能从血管内治疗方案中获益。我们评估了严重CVT患者机械取栓术的血管造影和临床结果。
2011年至2018年间，除标准抗凝治疗外，对13例CVT患者进行了血管内手术。回顾性分析临床和影像学参数、手术细节以及血管造影和临床结果。
共进行了14次取栓手术。86%（12/14）的病例实现了闭塞窦的成功再通；其中，29%完全再通。手术并发症包括1例（7%）横窦穿孔。14%（2/14）的病例出现颅内出血恶化。13例患者中有12例（92%）获得了良好的临床结局（改良Rankin量表评分为0 - 2）。
经静脉机械取栓术可行、安全且有效，可使闭塞的硬脑膜窦获得较高的成功再通率。对于某些对标准药物治疗难治的严重CVT患者，它可能是一种挽救性治疗方法。
