Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study

Current standard care for acute cerebral venous sinus thrombosis (CVST) includes either intravenous heparin or subcutaneous low-molecular-weight heparin, but patients with refractory CVST, despite adequate anticoagulation therapy, may benefit from mechanical thrombectomy (MT). A retrospective study...

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Main Authors: Farzaneh Jedi, Gero Dethlefs, Till-Karsten Hauser, Florian Hennersdorf, Annerose Mengel, Ulrike Ernemann, Benjamin Bender
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/21/6381
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author Farzaneh Jedi
Gero Dethlefs
Till-Karsten Hauser
Florian Hennersdorf
Annerose Mengel
Ulrike Ernemann
Benjamin Bender
author_facet Farzaneh Jedi
Gero Dethlefs
Till-Karsten Hauser
Florian Hennersdorf
Annerose Mengel
Ulrike Ernemann
Benjamin Bender
author_sort Farzaneh Jedi
collection DOAJ
description Current standard care for acute cerebral venous sinus thrombosis (CVST) includes either intravenous heparin or subcutaneous low-molecular-weight heparin, but patients with refractory CVST, despite adequate anticoagulation therapy, may benefit from mechanical thrombectomy (MT). A retrospective study of patients with CVST, who underwent MT between 2011 and 2019, was performed looking at procedure success rate and clinical outcomes. Two raters evaluated the cerebral venous system of every patient before and after the intervention using the following scoring system: (0) No obvious thrombosis; (1) thrombosis without impaired blood flow; (2) thrombosis with impaired blood flow; (3) and thrombosis with complete vascular occlusion. The success of MT was measured using a score quotient (Q = A/B), dividing the sum of the patient’s scores after the intervention (A) by the sum of scores before the intervention (B). Overall, 21 MTs were performed on 20 patients with refractory or severe CVST. Clinical improvement was seen in 61.9% during hospital stay and in 80% at 6-month follow-up, with complete recovery in 70% of patients. Patients with favorable outcomes had significantly lower recanalization quotients (<i>p</i> = 0.008). Our study provides evidence supporting that MT may be a safe and effective treatment with favorable clinical outcomes for selected patients with CVST.
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spelling doaj.art-5128257ad8c24bedaa66d8f758b5c0fb2023-11-24T05:16:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011121638110.3390/jcm11216381Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center StudyFarzaneh Jedi0Gero Dethlefs1Till-Karsten Hauser2Florian Hennersdorf3Annerose Mengel4Ulrike Ernemann5Benjamin Bender6Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Neurology and Stroke, Hertie-Institute for Clinical Brain Research, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyDepartment of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, GermanyCurrent standard care for acute cerebral venous sinus thrombosis (CVST) includes either intravenous heparin or subcutaneous low-molecular-weight heparin, but patients with refractory CVST, despite adequate anticoagulation therapy, may benefit from mechanical thrombectomy (MT). A retrospective study of patients with CVST, who underwent MT between 2011 and 2019, was performed looking at procedure success rate and clinical outcomes. Two raters evaluated the cerebral venous system of every patient before and after the intervention using the following scoring system: (0) No obvious thrombosis; (1) thrombosis without impaired blood flow; (2) thrombosis with impaired blood flow; (3) and thrombosis with complete vascular occlusion. The success of MT was measured using a score quotient (Q = A/B), dividing the sum of the patient’s scores after the intervention (A) by the sum of scores before the intervention (B). Overall, 21 MTs were performed on 20 patients with refractory or severe CVST. Clinical improvement was seen in 61.9% during hospital stay and in 80% at 6-month follow-up, with complete recovery in 70% of patients. Patients with favorable outcomes had significantly lower recanalization quotients (<i>p</i> = 0.008). Our study provides evidence supporting that MT may be a safe and effective treatment with favorable clinical outcomes for selected patients with CVST.https://www.mdpi.com/2077-0383/11/21/6381cerebral venous sinus thrombosismechanical thrombectomyendovascular therapythrombolysis
spellingShingle Farzaneh Jedi
Gero Dethlefs
Till-Karsten Hauser
Florian Hennersdorf
Annerose Mengel
Ulrike Ernemann
Benjamin Bender
Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
Journal of Clinical Medicine
cerebral venous sinus thrombosis
mechanical thrombectomy
endovascular therapy
thrombolysis
title Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
title_full Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
title_fullStr Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
title_full_unstemmed Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
title_short Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study
title_sort mechanical thrombectomy in cerebral venous sinus thrombosis reports of a retrospective single center study
topic cerebral venous sinus thrombosis
mechanical thrombectomy
endovascular therapy
thrombolysis
url https://www.mdpi.com/2077-0383/11/21/6381
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