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2015 ; 28
(2
): 177-83
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Cerebral Venous Sinus Thrombosis: Successful Treatment of Two Patients Using the
Penumbra System and Review of Endovascular Approaches
#MMPMID25923675
Liao W
; Liu Y
; Gu W
; Yang J
; Chen C
; Liu F
; Zeng F
; Wang X
Neuroradiol J
2015[Apr]; 28
(2
): 177-83
PMID25923675
show ga
Cerebral venous sinus thrombosis (CVST) is an uncommon but potentially
life-threatening condition. When showing resistance to treatment or a malignant
progression despite anticoagulant therapy, endovascular interventional treatment
is of help. The Penumbra System (PS), a novel thrombectomy device specifically
designed to remove the thrombus in acute ischemic stroke, also proved to be an
effective device for mechanical recanalization of CVST. We first reported two
cases successfully treated using the PS in the management of intractable CVST in
Asia, and analyzed the technical differences of use of the device through a
systematic review of the literature.One patient underwent mechanical thrombectomy
of the thrombosed superior sagittal sinus using the 0.054-inch PS catheter when
direct pharmacological thrombolysis failed. The other patient underwent
mechanical thrombectomy using the 0.041-inch PS catheter with adjuvant local
pharmacological thrombolysis. Literature reports on the use of the PS in patients
with CVST were reviewed.Successful venous recanalization was achieved using the
PS. The patients improved symptomatically following the intervention. Literature
reports showed that the PS can be successfully applied for treatment of CVST,
though the methods used previously were diverse.The PS has proved to be effective
in the rapid recanalization of CVST, but different treatment techniques exist.
The solution to these problems depends on more clinical trials as well as further
improvements to devices.