Zhang Mingsi, Jiang Feixin, Wen Qingyan, Chen Yiman, Zhang Zhiquan, Zhang Min, Zhong Jianxin
Department of Neurology, Jiangmen Central Hospital, Jiangmen, China.
Department of Neurology, Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University, Shanwei, China.
Front Neurol. 2025 Mar 7;16:1519308. doi: 10.3389/fneur.2025.1519308. eCollection 2025.
Cerebral venous sinus thrombosis (CVST) is an unusual cause of stroke. Currently, standard anticoagulant therapy does not have satisfactory efficacy for treating some cases of hemorrhagic CVST. Therefore, we explored the efficacy and safety of the combination of sliding balloon-assisted thrombectomy with aspiration and intrasinus urokinase thrombolysis for the treatment of CVST patients with intracranial hemorrhage (ICH).
We retrospectively analyzed the clinical, imaging and follow-up data of 10 CVST patients with ICH who underwent sliding balloon-assisted thrombectomy combined with aspiration and intrasinus thrombolysis with urokinase from February 2022 to June 2023. Complete recanalization and partial recanalization in the cerebral venous sinus were defined as imaging outcomes, and the modified Rankin score (mRS) at the 3-month and 6-month follow-ups was used to evaluate clinical efficacy.
A total of 10 CVST patients aged 18-68 years were enrolled, including 5 males. All of the patients was diagnosed with ICH by noncontrast CT and with thrombosis at 3 or more venous sinuses by digital subtraction angiography (DSA). After treatment, complete recanalization was achieved in 6 patients, and partial recanalization was achieved in 4 patients. At the 3- and 6-month follow-up, all 10 patients showed neurological independence (mRS score ≤ 2), without any signs of symptom aggravation, cerebral hematoma enlargement, pulmonary embolism or other complications after treatment.
These results indicated that the combination of sliding balloon-assisted thrombectomy, aspiration and intrasinus urokinase thrombolysis may be safe and effective for the treatment of CVST patients with intracranial hemorrhage.
脑静脉窦血栓形成（CVST）是一种不常见的中风病因。目前，标准抗凝治疗对某些出血性CVST病例的治疗效果并不理想。因此，我们探讨了滑动球囊辅助血栓切除术联合抽吸及窦内尿激酶溶栓治疗颅内出血（ICH）的CVST患者的疗效和安全性。
我们回顾性分析了2022年2月至2023年6月期间10例接受滑动球囊辅助血栓切除术联合抽吸及窦内尿激酶溶栓治疗的ICH的CVST患者的临床、影像学和随访数据。脑静脉窦的完全再通和部分再通被定义为影像学结果，并使用3个月和6个月随访时的改良Rankin量表（mRS）评估临床疗效。
共纳入10例年龄在18 - 68岁的CVST患者，其中男性5例。所有患者均通过非增强CT诊断为ICH，并通过数字减影血管造影（DSA）诊断为3个或更多静脉窦血栓形成。治疗后，6例患者实现了完全再通，4例患者实现了部分再通。在3个月和6个月的随访中，所有10例患者均表现出神经功能独立（mRS评分≤2），治疗后无任何症状加重、脑血肿扩大、肺栓塞或其他并发症的迹象。
这些结果表明，滑动球囊辅助血栓切除术、抽吸及窦内尿激酶溶栓联合应用可能对治疗颅内出血的CVST患者安全有效。
