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Endovascular Treatment of Cerebral Venous Sinus Thrombosis: A Literature Review

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Book cover Cerebral Venous System in Acute and Chronic Brain Injuries

Part of the book series: Springer Series in Translational Stroke Research ((SSTSR))

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Abstract

Cerebral venous sinus thrombosis (CVST) is a rare but life threatening pathophysiological process. Currently, the first-line treatment for the CVST is anticoagulation with intravenous unfractionated heparin or subcutaneous low-molecular-weight heparin (LMWH). However, for some critical CVST patients, especially when the thrombi are refractory to the regular anticoagulation with heparin or LMWH, many studies have confirmed the safety and efficacy of endovascular treatment. It includes the methods of local chemical thrombolysis, mechanical thrombectomy and stenting. This review would focus on the three types of techniques of endovascular treatment and its latest developments.

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References

  1. Gowers WR. Manual of diseases of the nervous system. 2nd ed. London: Churchill; 1888.

    Google Scholar 

  2. Kalbag R, Woolf A. Cerebral venous thrombosis. London: Oxford University Press; 1967.

    Google Scholar 

  3. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6:162–70.

    Article  CAS  Google Scholar 

  4. Canhão P, Ferro JM, Lindgren AG, Bousser MG, Stam J, Barinagarrementeria F, et al. Causes and predictors of death in cerebral venous thrombosis. Stroke. 2005;36:1720–5.

    Article  Google Scholar 

  5. Ferro JM, Canhão P. Cerebral venous and dural sinus thrombosis. Pract Neurol. 2003;3:214–9.

    Article  Google Scholar 

  6. Deveber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral sinovenous thrombosis in children. N Engl J Med. 2001;345:417–23.

    Article  CAS  Google Scholar 

  7. Agnelli G, Verso M. Epidemiology of cerebral vein and sinus thrombosis. Front Neurol Neurosci. 2008;23:16–22.

    PubMed  Google Scholar 

  8. Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352:1791–8.

    Article  CAS  Google Scholar 

  9. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F, 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;35:664–70.

    Article  Google Scholar 

  10. Qiu Z, Sang H, Dai Q, Xu G. Endovascular treatments for cerebral venous sinus thrombosis. J Thromb Thrombolysis. 2015;40:353–62.

    Article  CAS  Google Scholar 

  11. Einhaupl KM, Villringer A, Meister W, Mehraein S, Garner C, Pellkofer M, et al. Heparin treatment in sinus venous thrombosis. Lancet. 1991;338:597–600.

    Article  CAS  Google Scholar 

  12. Cohen JE, Boitsova S, Itshayek E. Cerebral venous sinus thrombosis. Isr Med Assoc J. 2009;11:685–8.

    PubMed  Google Scholar 

  13. Hartel M, Kluczewska E, Gancarczyk-Urlik E, Pierzcha K, Bien K, Zastawnik A. Cerebral venous sinus thrombosis. Phlebology. 2015;30(1):3–10.

    Article  Google Scholar 

  14. Canhão P, Ferro JM, Stam J. Cerebral venous thrombosis. In: Vinken PJ, Bruyn GW, editors. Handbook of clinical neurology. Amsterdam: Elsevier; 2008. p. 809–22.

    Google Scholar 

  15. Corvol JC, Oppenheim C, Manaï R, Logak M, Dormont D, Samson Y, et al. Diffusion-weighted magnetic resonance imaging in a case of cerebral venous thrombosis. Stroke. 1998;29:2649–52.

    Article  CAS  Google Scholar 

  16. Masuhr F, Mehraein S, Einhäupl K. Cerebral venous and sinus thrombosis. J Neurol. 2004;251:11–23.

    Article  CAS  Google Scholar 

  17. Stam J. Cerebral venous and sinus thrombosis: incidence and causes. Adv Neurol. 2003;92:225–32.

    PubMed  Google Scholar 

  18. Ebright JR, Pace MT, Niazi AF. Septic thrombosis of the cavernous sinuses. Arch Intern Med. 2001;161:2671–6.

    Article  CAS  Google Scholar 

  19. Agayev A, Yilmaz S. Images in clinical medicine. Cavernous sinus thrombosis. N Engl J Med. 2008;359:2266.

    Article  CAS  Google Scholar 

  20. Roland T, Jacobs J, Rappaport A, et al. Unenhanced brain CT is useful to decide on further imaging in suspected venous sinus thrombosis. Clin Radiol. 2010;65:34–9.

    Article  CAS  Google Scholar 

  21. Huang Z, Chu J, Yang Z. Is it possible to accurately diagnose cerebral venous sinus thrombosis on non-contrast CT? Diagn Imaging Intervent Radiol. 2015;24:9–13.

    Google Scholar 

  22. Huang Z, Lin L, Jiang X, Huang Z, Guan J. Unenhanced CT density of cerebral venous sinus in acute cerebral venous sinus thrombosis. Diagn Imaging Intervent Radiol. 2016;25(1):50–4.

    Google Scholar 

  23. Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics. 2006;26(1 Suppl):S19–41.

    Article  Google Scholar 

  24. Buonanno F, Moody DM, Ball MR, et al. Computed cranial tomographic findings in cerebral sino-venous occlusion. J Comput Assist Tomogr. 1978;2:281–90.

    Article  CAS  Google Scholar 

  25. Wang JL, Ling F, Ji X, et al. Utilization of digital subtraction angiography in the diagnosis and treatment of dural sinus thrombosus. Chin Comput Med Imaging. 2016;12(1):49–51.

    Google Scholar 

  26. Wang R-f, Sun S-x, Huang N-d, He X-h, Fu W-j. Analysis of imaging diagnosis and misdiagnosis causes of cerebral venous thrombosis (a report of 27 cases). Clin Misdiagn Misther. 2011;24(3):37–9.

    Google Scholar 

  27. Einhaupl K, Stam J, Bousser MG, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol. 2010;17:1229–35.

    Article  CAS  Google Scholar 

  28. Saposnik G, Barinagarrementeria F, Brown RD Jr, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:1158–92.

    Article  Google Scholar 

  29. Bousser MG, Chiras J, Bories J, et al. Cerebral venous thrombosis are view of 38 cases. Stroke. 1985;16:199–213.

    Article  CAS  Google Scholar 

  30. Hirooka K, Yasumura Y, Tsujita Y, et al. An enhanced method for left ventricular volume and ejection fraction by triggered harmonic contrast echocardiography. Int J Card Imaging. 2001;17(4):253–61.

    Article  CAS  Google Scholar 

  31. Aleszewicz-Baranowska J, Fryze I, Fiszer R, et al. Contrast echocardiography in children. Wiad Lek. 2000;53(9-10):481–7.

    CAS  PubMed  Google Scholar 

  32. Hamilton A, Huang SL, Warnick D, et al. Left ventricular thrombus enhancement after intravenous injection of echogenic immunoliposomes: studies in a new experimental model. Circulation. 2002;105:2772–8.

    Article  Google Scholar 

  33. Gala NB, Agarwa N, Barrese J, Gandhi CD, Prestigiacomo CJ. Current endovascular treatment options of dural venous sinus thrombosis: a review of the literature. J Neurointerv Surg. 2013;5(1):28–34.

    Article  Google Scholar 

  34. Rajan Vivakaran TT, Srinivas D, Kulkarni GB, Somanna S. The role of decompressive craniectomy in cerebral venous sinus thrombosis. J Neurosurg. 2012;117(4):738–44.

    Article  Google Scholar 

  35. Waugh J, Plumb P, Rollins N, et al. Prolonged direct catheter thrombolysis of cerebral venous sinus thrombosis in children: a case series. J Child Neurol. 2012;27:337–45.

    Article  Google Scholar 

  36. Li G, Zeng X, Hussain M, et al. Safety and validity of mechanical thrombectomy and thrombolysis on severe cerebral venous sinus thrombosis. Neurosurgery. 2013;72:730–8.

    Article  Google Scholar 

  37. Yue X, Xi G, Zhou Z, et al. Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis. J Thromb Thrombolysis. 2010;29:361–7.

    Article  Google Scholar 

  38. Mortimer AM, Bradley MD, O’Leary S, et al. Endovascular treatment of children with cerebral venous sinus thrombosis: a case series. Pediatr Neurol. 2013;49:305–12.

    Article  Google Scholar 

  39. Poulsen FR, Hogedal L, Stilling MV, et al. Good clinical outcome after combined endovascular and neurosurgical treatment of cerebral venous sinus thrombosis. Dan Med J. 2013;60:A4724.

    PubMed  Google Scholar 

  40. Guo XB, Fu Z, Song LJ, et al. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium. Eur J Radiol. 2013;82:165–8.

    Article  Google Scholar 

  41. Guo XB, Song LJ, Guan S. Endovascular treatment of chronic, recurrent headache secondary to chronic cerebral venous sinus thrombosis. J Stroke Cerebrovasc Dis. 2014;23:560–3.

    Article  Google Scholar 

  42. Guo XB, Guan S, Fan Y, et al. Local thrombolysis for severe cerebral venous sinus thrombosis. AJNR Am J Neuroradiol. 2012;33:1187–90.

    Article  Google Scholar 

  43. Kumar S, Rajshekher G, Reddy CR, et al. Intrasinus thrombolysis in cerebral venous sinus thrombosis: single-center experience in 19 patients. Neurol India. 2010;58:225.

    Article  Google Scholar 

  44. Siddiqui FM, Banerjee C, Zuurbier SM, et al. Mechanical thrombectomy versus intrasinus thrombolysis for cerebral venous sinus thrombosis: a non-randomized comparison. Interv Neuroradiol. 2014;20:336–44.

    Article  Google Scholar 

  45. Wasay M, Bakshi R, Kojan S, et al. Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis. Stroke. 2001;32:2310–7.

    Article  CAS  Google Scholar 

  46. Coutinho JM, Seelig R, Bousser MG, et al. Treatment variations in cerebral venous thrombosis: an international survey. Cerebrovasc Dis. 2011;32:298–300.

    Article  CAS  Google Scholar 

  47. Zeumer H, Freitag HJ, Zanella F, et al. Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA). Neuroradiology. 1993;35:159–62.

    Article  CAS  Google Scholar 

  48. Kim SY, Suh JH. Direct endovascular thrombolytic therapy for dural sinus thrombosis: infusion of alteplase. AJNR Am J Neuroradiol. 1997;18:639–45.

    CAS  PubMed  Google Scholar 

  49. Coutinho JM, Middeldorp S, Stam J. Advances in the treatment of cerebral venous thrombosis. Curr Treat Options Neurol. 2014;16:299.

    Article  CAS  Google Scholar 

  50. Canhao P, Falcao F, Ferro JM. Thrombolytics for cerebral sinus thrombosis: a systematic review. Cerebrovasc Dis. 2003;15:159–66.

    Article  CAS  Google Scholar 

  51. Bagley LJ, Hurst R, Galetta S, et al. Use of a microsnare to aid direct thrombolytic therapy of dural sinus thrombosis. Am J Roentgenol. 1998;170:784–6.

    Article  CAS  Google Scholar 

  52. Xia Z, You J, Wu T, Nie H. Clinical study of the rt-PA combined endovascular therapeutic effect on severe venous sinus thrombosis. Chin J Pract Nerv Dis. 2013;15(20):30–1.

    Google Scholar 

  53. Garge SS, Shah VD, Surya N, et al. Role of local thrombolysis in cerebral hemorrhagic venous infarct. Neurol India. 2014;62:521–4. https://doi.org/10.4103/0028-3886.144448.

    Article  PubMed  Google Scholar 

  54. Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg. 2013;5:49–56.

    Article  Google Scholar 

  55. Chow K, Gobin YP, Saver J, et al. Endovascular treatment of dural sinus thrombosis with rheolytic thrombectomy and intraarterialintraarterial thrombolysis. Stroke. 2000;31:1420–5.

    Article  CAS  Google Scholar 

  56. Curtin KR, Shaibani A, Resnick SA, et al. Rheolytic catheter thrombectomy, balloon angioplasty, and direct recombinant tissue plasminogen activator thrombolysis of dural sinus thrombosis with preexisting hemorrhagic infarctions. AJNR Am J Neuroradiol. 2004;25:1807–11.

    PubMed  Google Scholar 

  57. Bishop FS, Finn MA, Samuelson M, et al. Endovascular balloon angioplasty for treatment of posttraumatic venous sinus thrombosis. Case report. J Neurosurg. 2009;111:17–21.

    Article  Google Scholar 

  58. Dentali F, Squizzato A, Gianni M, et al. Safety of thrombolysis in cerebral venous thrombosis. A systematic review of the literature. Thromb Haemost. 2010;104:1055–62.

    Article  CAS  Google Scholar 

  59. Dowd CF, Malek AM, Phatouros CC, Hemphill JC III. Application of a rheolytic thrombectomy device in the treatment of dural sinus thrombosis: a new technique. AJNR Am J Neuroradiol. 1999;20:568–70.

    CAS  PubMed  Google Scholar 

  60. Smith TP, Higashida RT, Barnwell SL, Halbach VV, Dowd CF, Fraser KW, et al. Treatment of dural sinus thrombosis by urokinase infusion. AJNR Am J Neuroradiol. 1994;15:801–7.

    CAS  PubMed  Google Scholar 

  61. Blackham KA. Extensive dural sinus thrombosis: successful recanalization with thrombolysis and a novel thrombectomy device. J Neurosurg. 2011;114:133–5.

    Article  Google Scholar 

  62. Froehler MT. Successful treatment of cerebral venous sinus thrombosis with the Solitaire FR thrombectomy device. J Neurointerv Surg. 2013;5:e45.

    Article  Google Scholar 

  63. Shaikh H, Pukenas BA, McIntosh A, et al. Combined use of Solitaire FR and penumbra devices for endovascular treatment of cerebral venous sinus thrombosis in a child. J Neurointerv Surg. 2015;7(3):e10.

    Article  Google Scholar 

  64. Qiu X-h, Li G-b, Cheng G-z. Thrombectomy and thrombolysis therapy in the analysis and application of interventional therapy for severe cerebral venous sinus thrombosis. J Gannan Med Univ. 2015;35(2):270–2.

    Google Scholar 

  65. Soleau SW, Schmidt R, Stevens S, et al. Extensive experience with dural sinus thrombosis. Neurosurgery. 2003;52:534–44.

    Article  Google Scholar 

  66. Frei D, Huddle D, Bellon R, et al. O-009 Mechanical balloon thromboembolectomy for the treatment of cerebral venous sinus thrombosis (CVT): a restropsective analysis of safety and efficacy in 65 consecutive patients. J Neurointerv Surg. 2011;3(Suppl 1):A4–5.

    Article  Google Scholar 

  67. Choulakian A, Alexander MJ. Mechanical thrombectomy with the penumbra system for treatment of venous sinus thrombosis. J Neurointerv Surg. 2010;2:153–6.

    Article  Google Scholar 

  68. Philips MF, Bagley LJ, Sinson GP, et al. Endovascular thrombolysis for symptomatic cerebral venous thrombosis. J Neurosurg. 1999;90:65–71.

    Article  CAS  Google Scholar 

  69. Kirsch J, Rasmussen PA, Masaryk TJ, et al. Adjunctive rheolytic thrombectomy for central venous sinus thrombosis: technical case report. Neurosurgery. 2007;60:e577–8.

    Article  Google Scholar 

  70. Ma J, Shui S, Han X, Guo D, Li TF, Yan L. Mechanical thrombectomy with Solitaire AB stents for the treatment of intracranial venous sinus thrombosis. Acta Radiol. 2016;57(12):1524–30.

    Article  Google Scholar 

  71. Horowitz M, Purdy P, Unwin H, et al. Treatment of dural sinus thrombosis using selective catheterization and urokinase. Ann Neurol. 1995;38(1):58–67.

    Article  CAS  Google Scholar 

  72. Shui S-F, Han X, Ma J, et al. Balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis. Neurol India. 2014;62:371–5.

    Article  Google Scholar 

  73. Kumpe DA, Bennett JL, Seinfeld J, et al. Dural sinus stent placement for idiopathic intracranial hypertension: clinical article. J Neurosurg. 2012;116(3):538–48.

    Article  Google Scholar 

  74. Li B, Wang J, Li S, Cao X, Liu X, Ma Y. Individualized endovascular treatment of cerebral venous thrombosis:analysis of 168 patients. Natl Med J China. 2009;89(3):164–6.

    Google Scholar 

  75. Song W-j, Hu S, Yan J-h, Chen W, Wen O. Endovascular treatment for severe cranial venous sinus thrombosis. Neural Inj Funct Reconstr. 2006;1(4):206–9.

    Google Scholar 

  76. Li B, Guo M, et al. Endovascular thrombolysis and stent angioplasty for obliteration in cerebral venous sinuses. Chin J Surg. 2002;40(12):890–2.

    PubMed  Google Scholar 

  77. Adachi H, Mineharu Y, Ishikawa T, Imamura H, Yamamoto S, Todo K, Yamagami H, Sakai N. Stenting for acute cerebral venous sinus thrombosis in the superior sagittal sinus. Interv Neuroradiol. 2015;21(6):719–23.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

    Liang Xu, Weilin Xu & Jianmin Zhang

  2. Brain Research Institute, Zhejiang University, Hangzhou, China

    Jianmin Zhang

  3. Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China

    Jianmin Zhang

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  1. Liang Xu
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  2. Weilin Xu
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  3. Jianmin Zhang
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Correspondence to Jianmin Zhang .

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Editors and Affiliations

  1. Department of Neurology, The Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China

    Min Lou

  2. Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

    Jianmin Zhang

  3. Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Yilong Wang

  4. Department of Neurosurgery Tangdu Hospital, PLA Air Force Medical University, Xian, USA

    Yan Qu

  5. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA

    Wuwei Feng

  6. Xuanwu Hospital Neurosurgery, Capital Medical University, Beijing, China

    Xunming Ji

  7. Department of Anesthesiology and Physiology, Loma Linda University, Loma Linda, CA, USA

    John H. Zhang

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Xu, L., Xu, W., Zhang, J. (2019). Endovascular Treatment of Cerebral Venous Sinus Thrombosis: A Literature Review. In: Lou, M., et al. Cerebral Venous System in Acute and Chronic Brain Injuries. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-96053-1_16

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  • DOI: https://doi.org/10.1007/978-3-319-96053-1_16

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