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Endovascular treatment for hemorrhagic cerebral venous sinus thrombosis: experience with 9 cases for 3 years
Shizhong Zhang1,2, Yanyan Hu3, Zhen Li2
1Department of Neurosurgery, Qilu Hospital of Shandong University NO. 758, Hefei Road, Shibei District, Qingdao 266035, Shangdong, China.
Insights
Endovascular treatment (EVT) effectively manages hemorrhagic cerebral venous sinus thrombosis (CVST). This study shows EVT leads to neurological improvement and sinus recanalization in patients with this condition.
Area of Science:
- Neurology
- Interventional Radiology
Background:
- Hemorrhagic cerebral venous sinus thrombosis (CVST) is a rare but severe condition.
- Treatment options for hemorrhagic CVST are limited, necessitating exploration of effective therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of endovascular treatment (EVT) for hemorrhagic CVST.
- To analyze treatment data to inform future therapeutic strategies for hemorrhagic CVST.
Main Methods:
- Retrospective analysis of nine patients with hemorrhagic CVST treated primarily with EVT.
- Data collected included patient characteristics, risk factors, thrombus location, symptoms, EVT techniques, clinical outcomes, sinus recanalization, recurrences, complications, and neurological deficits.
Main Results:
- All nine patients underwent catheter thrombolysis and/or mechanical thrombectomy, with stent retrievers used in seven.
- Neurological and symptomatic improvement was observed in all patients; six achieved good outcomes.
- Complete sinus recanalization occurred in seven patients, with no reported thrombus recurrences or deaths.
Conclusions:
- Endovascular treatment (EVT) is a safe and effective therapeutic option for hemorrhagic cerebral venous sinus thrombosis.
- EVT demonstrates potential for successful management and improved outcomes in patients with this critical condition.
Aim:
We experienced a series of patients with hemorrhagic CVST, who were successfully treated with endovascular treatment (EVT). The aim was to explore the best scheme for the future through our treatment data of hemorrhagic CVST.
Material And Methods:
A retrospective analysis was conducted, selecting nine hemorrhagic CVST patients, who were mainly treated with EVT. Characteristics of hemorrhagic CVST were recorded, including risk factors, thrombus location, presenting symptoms, and treatment details included type of EVT. We also recorded clinical outcomes, degree of sinus recanalization, thrombus recurrences, periprocedural complications, degree of neurological deficit at last follow-up.
Results:
Catheter thrombolysis and mechanical thrombectomy were applied in all of the nine hemorrhagic CVST patients, stent retriever was used in 7 patients, one of them combined with balloon-assisted thrombectomy. Besides EVT, two patients accepted emergency surgical decompression, one in the local hospital, and the other in our hospital. The follow-up duration ranged from 4 to 28 months. All of them have a neurological and symptomatic improvement, 6 patients have a good outcome, the rest 3 patients have a poor outcome, no thrombus recurrences and death in them. Seven patients had complete recanalization and two patients had partial recanalization at last follow-up.
Conclusion:
EVT is an effective and safe procedure for potentially catastrophic hemorrhagic cerebral venous sinus thrombosis.
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