Mechanical thrombectomy in patient with cerebral venous sinus thrombosis: case report

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Cerebral venous sinus thrombosis is a rare type of stroke and standard treatment involves anticoagulation. However, in some patients anticoagulation does not lead to occlusion recanalization and clinical improvement. Endovascular treatment can serve as an effective and safe option for this group of patients. We present a case report of 24-years-old patient with cerebral venous sinus thrombosis due to combined oral contraceptive pills. Patient was refractory to anticoagulation treatment. Mechanical thrombectomy was performed with thrombus aspiration from superior sagittal and transverse cerebral sinuses. After 6 days patient was discharged with good functional and neurological outcome.

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作者简介

M. Zabelin

Ministry of Health of the Moscow Region

编辑信件的主要联系方式.
Email: erho@bk.ru

MD

俄罗斯联邦, Krasnogorsk

Yu. Raikhman

Voskresensk Hospital

Email: erho@bk.ru
俄罗斯联邦, Moscow Region, Voskresensk

G. Ayvazyan

Voskresensk Hospital

Email: erho@bk.ru
ORCID iD: 0000-0002-3968-6180
俄罗斯联邦, Moscow Region, Voskresensk

M. Kuznetsov

Voskresensk Hospital

Email: erho@bk.ru
ORCID iD: 0009-0004-5184-0517
俄罗斯联邦, Moscow Region, Voskresensk

M. Glezer

Ministry of Health of the Moscow Region; First I.M. Sechenov Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Moscow Regional Research and Clinical Institute

Email: erho@bk.ru
ORCID iD: 0000-0002-0995-1924
SPIN 代码: 6336-1648

Professor, MD

俄罗斯联邦, Krasnogorsk; Moscow; Moscow

A. Azarov

Ministry of Health of the Moscow Region; First I.M. Sechenov Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Moscow Regional Research and Clinical Institute

Email: erho@bk.ru
ORCID iD: 0000-0001-7061-337X
SPIN 代码: 1149-6426

MD

俄罗斯联邦, Krasnogorsk; Moscow; Moscow

D. Tyutnev

Orekhovo-Zuyevo Hospital

Email: erho@bk.ru
ORCID iD: 0009-0001-7485-8208
俄罗斯联邦, Moscow Region, Orekhovo-Zuyevo

T. Kuropiy

Voskresensk Hospital

Email: erho@bk.ru
ORCID iD: 0000-0001-6916-4845
SPIN 代码: 9361-0403
俄罗斯联邦, Moscow Region, Voskresensk

参考

  1. Bousser M.G., Ferro J.M. Cerebral venous thrombosis: an update. Lancet Neurol. 2007; 6 (2): 162–70. doi: 10.1016/S1474-4422(07)70029-7
  2. Rezoagli E., Bonaventura A., Coutinho J.M. et al. Incidence Rates and Case-Fatality Rates of Cerebral Vein Thrombosis: A Population-Based Study. Stroke. 2021; 52 (11): 3578–85. doi: 10.1161/STROKEAHA.121.034202
  3. Alet M., Ciardi C., Alemán A. et al. Cerebral venous thrombosis in Argentina: clinical presentation, predisposing factors, outcomes and literature review. J Stroke Cerebrovasc Dis. 2020; 29 (10): 105145. doi: 10.1016/j.jstrokecerebrovasdis.2020.105145
  4. Idiculla P.S., Gurala D., Palanisamy M. et al. Cerebral Venous Thrombosis: A Comprehensive Review. Eur Neurol. 2020; 83 (4): 369–79. doi: 10.1159/000509802
  5. Ferro J.M., Canhão P., Stam J. et al. ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004; 35 (3): 664–70. doi: 10.1161/01.STR.0000117571.76197.26
  6. Zhang S., Zhao H., Li H. et al. Decompressive craniectomy in hemorrhagic cerebral venous thrombosis: clinicoradiological features and risk factors. J Neurosurg. 2017; 127 (4): 709–15. doi: 10.3171/2016.8.JNS161112
  7. Ferro J.M., Bousser M.G., Canhão P. et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis. Eur J Neurol. 2017; 24: 1203–13. doi: 10.1111/ene.13381
  8. Xu W., Gao L., Li T. et al. The performance of CT versus MRI in the differential diagnosis of cerebral venous thrombosis. Thromb Haemost. 2018; 118: 1067–77. doi: 10.1055/s-0038-1642636
  9. Alajmi E., Zung J., Duquet-Armand M. et al. Prevalence of venous infarction in patients with cerebral venous thrombosis: baseline diffusion-weighted MRI and follow-up MRI. Stroke. 2023; 54: 1808–14. doi: 10.1161/STROKEAHA.122.042336
  10. Misra U.K., Kalita J., Chandra S. et al. Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial. Eur J Neurol. 2012; 19: 1030–6. doi: 10.1111/j.1468-1331.2012.03690
  11. Fan Y., Yu J., Chen H. et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of cerebral venous sinus thrombosis. Stroke Vasc Neurol. 2020; 5: 152–8. doi: 10.1136/svn-2020-000358
  12. Kim D.J., Honig A., Alimohammadi A. et al. Recanalization and outcomes after cerebral venous thrombosis: a systematic review and meta-analysis. Res Pract Thromb Haemost. 2023; 7: 100143: doi: 10.1016/j.rpth.2023.100143
  13. Yaghi S., Shu L.., Bakradze E et al. Direct oral anticoagulants versus warfarin in the treatment of cerebral venous thrombosis (ACTION-CVT): a multicenter international study. Stroke. 2022; 53: 728–38. doi: 10.1161/STROKEAHA.121.037541
  14. Yaghi S., Saldanha I.J., Misquith C. et al. Direct oral anticoagulants versus vitamin K antagonists in cerebral venous thrombosis: a systematic review and meta-analysis. Stroke. 2022; 53: 3014–24. doi: 10.1161/STROKEAHA.122.039579
  15. Paybast S., Mohamadian R., Emami A. et al. Safety and efficacy of endovascular thrombolysis in patients with acute cerebral venous sinus thrombosis: a systematic review. Interv Neuroradiol. 2024; 30 (5): 746–58. doi: 10.1177/15910199221143418
  16. Liao C.H., Liao N.C., Chen W.H. et al. Endovascular Mechanical Thrombectomy and On-Site Chemical Thrombolysis for Severe Cerebral Venous Sinus Thrombosis. Sci Rep. 2020; 10: 4937. doi: 10.1038/s41598-020-61884-5

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2. Fig. 1. Computed tomography on admission, visualized area of reduced density of round shape with a diameter of 19 mm in the thalamus on the left surrounded by a zone of perifocal edema without dislocation of median structures (shown by arrows): a – axial projection; б – sagittal projection; в – coronal projection

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3. Fig. 2. Diagnostic angiography through a guidecatheter: a – guidecatheter (indicated by arrows) is placed in the left sigmoid sinus; б – angiography of the transverse and superior sagittal sinuses, thrombotic masses are visualized in the superior sagittal sinus and distal part of the transverse sinuses (indicated by arrows)

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4. Fig. 3. Balloon angioplasty of the superior sagittal and left transverse sinus: a – balloon catheter 3.5×25 mm (indicated by arrows) in the superior sagittal sinus; б – balloon catheter 3.5×25 mm (indicated by arrows) in the proximal part of the superior sagittal sinus; в – balloon catheter 5.0×30 mm (indicated by arrows) in the left transverse sinus

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5. Fig. 4. Angiography and endovascular thrombus extraction from the superior sagittal sinus: a – venous phase after angiography of the right internal carotid artery, residual thrombotic masses in the middle and proximal parts of the superior sagittal sinus are visualized (indicated by arrows); б – thromboaspiration of residual thrombotic masses, an aspiration catheter (indicated by arrows) was guided into the superior sagittal sinus through a guidewire (indicated by triangles)

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6. Fig. 5. Control angiography after endovascular thromboextraction: a – arterial phase; б – venous phase, complete restoration of outflow along the upper sagittal (indicated by arrows) and left transverse sinuses is visualized (indicated by triangles)

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7. Fig. 6. Computed tomography 9 days after endovascular thromboextraction, hypodense focus is visualized in the basal nuclei area on the left (shown by arrows): a – axial projection; б – sagittal projection; в – coronal projection

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