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Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis

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Abstract

To investigate the safety and efficacy of endovascular therapy with combined intra-arterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis. Of the 28 consecutive patients with cerebral venous sinus thrombosis admitted to our hospital in recent 3 years, six patients underwent combined intra-arterial and intravenous thrombolysis. For each patient, local contact thrombolysis was performed with balloon catheter to break clot and urokinase infused for thrombolysis in sinus. At the same time, urokinase (100,000 IU/h) was infused intra-arterially via internal carotid artery to dissolve the venous thrombi. Neurologic outcomes, Glasgow coma scale (GCS), neuroimaging results and modified Rankin Scale score (mRS) were recorded. Of the six treated patients, two were males and four females. Their mean age was 38 ± 13 (range from 22 to 57) years. Completely recanalization was observed in five patients, whose clinical symptoms recovered completely (mRS score 0). One patient in whom thrombolysis was delayed died the day after the procedure. Endovascular treatment with combined intra-arterial and intravenous thrombolysis may improve neurological outcomes of severe cerebral venous sinus thrombosis.

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Abbreviations

CSVT:

Cerebral sinus venous thrombosis

CT:

Computed tomography

GCS:

Glasgow coma scale

ICT:

Intracranial circulation time

mRS:

Modified Rankin Scale score

SSS:

Superior sagittal sinus

STS:

Straight sinus

TS:

Tranverse sinus

SS:

Sigmoid sinus

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Correspondence to Xinfeng Liu.

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Yue, X., Xi, G., Zhou, Z. et al. Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis. J Thromb Thrombolysis 29, 361–367 (2010). https://doi.org/10.1007/s11239-009-0386-3

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Keywords

  • Balloon
  • Cerebral sinus venous thrombosis
  • Endovascular treatment
  • Intra-arterial
  • Thrombolysis