title: Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis.
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.
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu Province, People's Republic of China.
authors.forename: Xuanye
authors.initials: X
authors.lastname: Yue
authors.forename: Gangming
authors.initials: G
authors.lastname: Xi
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Zhou
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000628:therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator
references.citation: J R Soc Med. 2000 May;93(5):241-3
references.pmid: 10884767
references.citation: J Neurol. 2004 Jan;251(1):11-23
references.pmid: 14999484
references.citation: Cardiovasc Intervent Radiol. 2007 Jul-Aug;30(4):675-87
references.pmid: 17573553
references.citation: Zhonghua Yi Xue Za Zhi. 2006 Mar 21;86(11):745-8
references.pmid: 16681947
references.citation: AJNR Am J Neuroradiol. 1997 Apr;18(4):639-45
references.pmid: 9127024
references.citation: J Neuroradiol. 1994 Apr;21(2):72-80
references.pmid: 8014660
references.citation: J Neurol Neurosurg Psychiatry. 2001 Jan;70(1):105-8
references.pmid: 11118257
references.citation: Neurol Med Chir (Tokyo). 2005 Dec;45(12):635-9
references.pmid: 16377952
references.citation: Stroke. 2000 Jun;31(6):1420-5
references.pmid: 10835466
references.citation: Stroke. 2005 Aug;36(8):1720-5
references.pmid: 16002765
references.citation: Neurology. 2004 Dec 28;63(12):2444-5
references.pmid: 15623729
references.citation: AJNR Am J Neuroradiol. 2004 Nov-Dec;25(10):1807-11
references.pmid: 15569752
references.citation: J Pediatr Hematol Oncol. 2006 Mar;28(3):196-9
references.pmid: 16679950
references.citation: Stroke. 2008 May;39(5):1487-90
references.pmid: 18340091
references.citation: Stroke. 1999 Mar;30(3):489-94
references.pmid: 10066841
references.citation: Cerebrovasc Dis. 2003;15(1-2):17-21
references.pmid: 12499706
references.citation: AJNR Am J Neuroradiol. 2000 Jan;21(1):143-5
references.pmid: 10669240
references.citation: Stroke. 2004 Mar;35(3):664-70
references.pmid: 14976332
references.citation: J Stroke Cerebrovasc Dis. 2008 Mar-Apr;17(2):95-100
references.pmid: 18346652
references.citation: J Neurosurg. 2009 Mar;110(3):442-5
references.pmid: 18834264
references.citation: Neurosurg Clin N Am. 2000 Jan;11(1):49-65, viii
references.pmid: 10565870
references.citation: J Neurol. 2000 Apr;247(4):252-8
references.pmid: 10836615
references.citation: Lancet Neurol. 2007 Feb;6(2):162-70
references.pmid: 17239803
references.citation: Stroke. 2007 Feb;38(2):337-42
references.pmid: 17204682