Sigmoid sinus thrombosis associated with internal jugular venous occlusion: direct thrombolytic treatment.
OBJECTIVE
To report our experience with transfemoral direct venous thrombolysis and angioplasty to treat central venous and dural sinus occlusion. The cases presented are rare examples of internal jugular occlusion associated with sigmoid sinus thrombosis.


RESULTS
Two middle-aged, symptomatic female patients were diagnosed with sigmoid sinus and internal jugular vein thrombosis. Venography was performed from a contralateral transfemoral approach, followed immediately by urokinase infusion directly to the occlusion using an intermittent "burst-bolus" technique. Successful thrombolysis of the sigmoid sinus and internal jugular vein was documented in both patients. In one case, a venous stenosis was treated with balloon angioplasty. Clinical signs and symptoms resolved in both patients.


CONCLUSIONS
Occluded dural sinuses and central veins can be treated with direct administration of thrombolytic agents. When an underlying stenosis is identified, balloon dilation should be used to reduce the likelihood of recurrence.
Gurley
M B
MB
Department of Radiology, Truman Medical Center, University of Missouri, Kansas City School of Medicine, Kansas City 64108, USA.
King
T S
TS
Tsai
F Y
FY
D000328:Adult; D000800:Angioplasty, Balloon; D003392:Cranial Sinuses; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011859:Radiography; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator