Artikel
Aspiration thrombectomy for severe dural sinus thrombosis: angiographic results and clinical outcome
Behandlung von Sinusthrombosen durch Aspirationsthrombektomie: angiographische und klinische Ergebnisse
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Autoren
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H. Henkes
- Klinik für Neuroradiologie, Katharinenhospital, Klinikum Stuttgart
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T. Güthe
- Klinik für Herz- und Gefäßkrankheiten, Katharinenhospital, Klinikum Stuttgart
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J. Reinartz
- Klinik für Neuroradiologie, Katharinenhospital, Klinikum Stuttgart
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E. Miloslavski
- Klinik für Neuroradiologie, Katharinenhospital, Klinikum Stuttgart
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A. Henn-Beilharz
- Klinik für Anästhesiologie und operative Intensivmedizin, Katharinenhospital, Klinikum Stuttgart
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N. Hopf
- Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
Text
Objective: Evaluation of angiographic and clinical results of the endovascular aspiration thrombectomy of patients with dural sinus thromboses.
Methods: Ten endovascular procedures were performed in nine patients with severe dural sinus thrombosis. All patients presented with pre-existing intracranial hemorrhage and progressive neurological deficits. In 7/9 patients retrograde direct access to the internal jugular vein with an 8 F sheath was used. Aspiration, mechanical clot disruption and thrombectomy were performed with regular 6F and 8F guiding catheters, which allowed massive thrombus removal from the superior sagittal and both transverse / sigmoid sinuses in all patients. All patients received IV heparin after the endovascular treatment.
Results: Significant sinus patency was achieved in all 9 patients, with a favourable clinical outcome in 8 patients. One patient deteriorated after the endovascular treatment due to increased brain edema and required decompressive craniectomy. Stent thrombosis and small subdural hematoma, both asymptomatic, were observed in one patient, respectively.
Conclusions: Venous sinus thrombosis is a rare entity with a potentially fatal outcome. Transvenous aspiration thrombectomy of dural sinus thrombosis is a simple, safe, intuitively functional and straightforward technique that yields a rapid recanalization of dural sinuses and can therefore supplement the standard therapy with systemic heparinization.
