Afshin Borhani Haghighi1, Mojtaba Mahmoodi2, Randall C Edgell3, Salvador Cruz-Flores3, Hosein Ghanaati4, Mohammad Jamshidi5, Osama O Zaidat6. 1. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran borhanihaghighi@yahoo.com. 2. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Department of Neurology and Psychiatry, St Louis University, St Louis, MO, USA. 4. Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. 5. Cardiovascular Health Institute, Tri-City Medical Center, Oceanside, CA, USA Department of Surgery, Oklahoma State University, Tulsa, OK, USA. 6. Department of Neurology, Neurosurgery and Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
Abstract
BACKGROUND: Endovascular treatment of cerebral venous sinus thrombosis (CVST) includes pharmacological and mechanical thrombolysis. METHODS: The authors searched the English literature on CVST from 1990 to 2012 for all case reports or case series of mechanical thrombectomy. RESULTS: A total of 64 patients were treated in all published studies. The techniques for mechanical thrombectomy included rheolytic thrombectomy with an AngioJet device (46.9%), clot retraction with the Penumbra system (4.7%), clot retraction with a Fogarty catheter (1.6%), clot retraction with a microsnare (3.1%), balloon venoplasty without stenting (18.7%), balloon venoplasty with stenting (4.7%), and an amalgam of techniques (18.7%). Nine (16.1%) patients died. At the most recent follow-up, 40 (62.5%) patients had no disability or minor disability and 7 (10.9%) patients had major disability. CONCLUSION: Randomized multiinstitutional clinical trials with larger number of participants are needed to sufficiently compare the effect of intrasinus thrombolysis and mechanical thrombectomy to standard-of-care anticoagulation therapy.
BACKGROUND: Endovascular treatment of cerebral venous sinus thrombosis (CVST) includes pharmacological and mechanical thrombolysis. METHODS: The authors searched the English literature on CVST from 1990 to 2012 for all case reports or case series of mechanical thrombectomy. RESULTS: A total of 64 patients were treated in all published studies. The techniques for mechanical thrombectomy included rheolytic thrombectomy with an AngioJet device (46.9%), clot retraction with the Penumbra system (4.7%), clot retraction with a Fogarty catheter (1.6%), clot retraction with a microsnare (3.1%), balloon venoplasty without stenting (18.7%), balloon venoplasty with stenting (4.7%), and an amalgam of techniques (18.7%). Nine (16.1%) patients died. At the most recent follow-up, 40 (62.5%) patients had no disability or minor disability and 7 (10.9%) patients had major disability. CONCLUSION: Randomized multiinstitutional clinical trials with larger number of participants are needed to sufficiently compare the effect of intrasinus thrombolysis and mechanical thrombectomy to standard-of-care anticoagulation therapy.
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