Baomin Li1, Mei Guo, Sheng Li, Maoqiang Wang. 1. Department of Interventioanl Radiology, General Hospital, People's Liberation Army, Beijing 100853, China.
Abstract
OBJECTIVE: To summarize the experience of treating the obliteration of the cerebral venous sinus in 17 patients by using direct thrombolysis and stent angioplasty. METHODS: All 17 patients with thrombosis and stenosis of the venous sinus were confirmed by digital subtraction angiography. Of these 3 patients had thrombosis in a single sinus and 14 had thrombosis in multiple sinuses. The circulating time was prolonged for over 13 seconds. The micro-catheter was preserved in the sinus for 5 days, followed by infusion of urokinase 1.5 million units and oral warfarin 3-5 mg each day. Stent angioplasty was done for 4 patients with obvious stenosis of the venous sinus detected by DSA after thrombosis. RESULTS: After contact thrombosis and stent angioplasty in sinuses of the 17 patients, remarkable recanalization of obliterated sinuses was achieved. After treatment, intracranial hypertension pressure (ICP) returned to normal in 7 patients, and 8 thrombosis relapsed in different degree after 7 days. Anticoagulation was prescribed. Only 2 patients showed the ICP above 280 mm H(2)O. No obvious relapse was found in 15 patients during the follow-up for 3-60 months. CONCLUSION: Our results demonstrated that successive thrombolysis and stent angioplasty for occlusion and thrombosis of the venous sinus are effective in promoting drainage of cerebral venous blood and rapidly decreasing ICP.
OBJECTIVE: To summarize the experience of treating the obliteration of the cerebral venous sinus in 17 patients by using direct thrombolysis and stent angioplasty. METHODS: All 17 patients with thrombosis and stenosis of the venous sinus were confirmed by digital subtraction angiography. Of these 3 patients had thrombosis in a single sinus and 14 had thrombosis in multiple sinuses. The circulating time was prolonged for over 13 seconds. The micro-catheter was preserved in the sinus for 5 days, followed by infusion of urokinase 1.5 million units and oral warfarin 3-5 mg each day. Stent angioplasty was done for 4 patients with obvious stenosis of the venous sinus detected by DSA after thrombosis. RESULTS: After contact thrombosis and stent angioplasty in sinuses of the 17 patients, remarkable recanalization of obliterated sinuses was achieved. After treatment, intracranial hypertension pressure (ICP) returned to normal in 7 patients, and 8 thrombosis relapsed in different degree after 7 days. Anticoagulation was prescribed. Only 2 patients showed the ICP above 280 mm H(2)O. No obvious relapse was found in 15 patients during the follow-up for 3-60 months. CONCLUSION: Our results demonstrated that successive thrombolysis and stent angioplasty for occlusion and thrombosis of the venous sinus are effective in promoting drainage of cerebral venous blood and rapidly decreasing ICP.
Authors: R Crosa; O Marabotto; G Meehroff; C Legnani; J Boschi; A Negrotto; K G Terbrugge; P Lasjaunias Journal: Interv Neuroradiol Date: 2007-09-13 Impact factor: 1.610