Palanisamy Prabakaran, Kramadhari Harshith, Badachi Sagar, Kumar G G Sharath, Aggipothu Balakrishna, Mathew Thomas, Sarma G R K, Nadig Raghunandan, Sucharitha M V, Deepalam Saikanth Reddy
Department of Interventional Radiology, St. Johns Medical College and Hospital, Bengaluru - 560029, Karnataka, India.
Department of Radiology, St. Johns Medical College and Hospital, Bengaluru - 560029, Karnataka, India.
Pol J Radiol. 2023 Aug 7;88:e349-e355. doi: 10.5114/pjr.2023.130768. eCollection 2023.
Stroke related to cerebral venous thrombosis (CVT) is uncommon, with untoward lethal outcomes. Systemic anticoagulation is the treatment of choice. However, some patients can be resistant to this treatment. Endovascular management with thrombolysis and mechanical thrombectomy can be a viable option in such cases.
We retrospectively reviewed the endovascular management used for CVT in 8 patients who failed to respond to standard anticoagulation therapy between December 2017 and December 2022 in our institute. Clinical profile, imaging parameters, endovascular procedure details, and outcomes in terms of angiographic findings and clinical follow-up were analysed.
In this period, a total of 8 patients underwent mechanical thrombectomy. The procedure was successful in all cases (8/8 = 100%), and 50% of them showed near total/complete recanalization; Perforation of the cortical veins was noted in 2 cases (~25%). Among the 8 patients, one died (1/8 = 12.5%) due to cardiac aetiology; the remaining 7 patients (87.5%) showed good clinical outcome with a modified Rankin Scale score 0 to 2.
Catheter-directed thrombolysis with mechanical thromboaspiration is a safe and effective treatment for cerebral venous sinus thrombosis not responding to anticoagulation.
与脑静脉血栓形成（CVT）相关的中风并不常见，会导致不良的致命后果。全身抗凝是首选治疗方法。然而，一些患者可能对此治疗有抵抗性。在这种情况下，采用溶栓和机械取栓的血管内治疗可能是一种可行的选择。
我们回顾性分析了2017年12月至2022年12月期间在我院8例对标准抗凝治疗无反应的CVT患者所采用的血管内治疗。分析了临床资料、影像学参数、血管内手术细节以及血管造影结果和临床随访方面的结果。
在此期间，共有8例患者接受了机械取栓术。该手术在所有病例中均成功（8/8 = 100%），其中50%显示接近完全/完全再通；2例（约25%）出现皮质静脉穿孔。在这8例患者中，1例（1/8 = 12.5%）因心脏病因死亡；其余7例（87.5%）临床结局良好，改良Rankin量表评分为0至2分。
导管定向溶栓联合机械血栓抽吸术是治疗对抗凝无反应的脑静脉窦血栓形成的一种安全有效的方法。
