Endovascular Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis: A Single-Center Experience.

Abstract

Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT. Endovascular procedures were performed in 13 patients with CVT in addition to standard anticoagulation therapy between 2011 and 2018. Clinical and radiologic parameters, procedure details, and angiographic and clinical outcomes were reviewed retrospectively. In total, 14 thrombectomy procedures were executed. Successful recanalization of the occluded sinus was achieved in 86% of cases (12/14); of those, 29% were recanalized completely. Procedural complications included perforation of the transverse sinus in 1 case (7%). Worsening of intracranial hemorrhage occurred in 14% (2/14) of cases. Favorable clinical outcome (modified Rankin Scale score 0-2) was achieved in 12 of 13 patients (92%). Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.