title: Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device.
abstract: BACKGROUND
  Cerebral venous sinus thrombosis (CVT) is an uncommon cause of stroke that is usually treated medically with intravenous heparin therapy followed by long-term anticoagulation therapy. A series of patients with CVT who underwent rheolytic thrombectomy with the AngioJet as a first-line adjunctive treatment in addition to standard anticoagulation therapy is presented.
  
  
  METHODS
  Prospectively maintained endovascular databases at two institutions were retrospectively reviewed. The available clinical and imaging data were compiled at each institution and combined for analysis.
  
  
  RESULTS
  Over 18 months, 13 patients (seven women and six men; age range 17-73 years, median age 45 years) with CVT were treated with rheolytic thrombectomy. Immediate (partial or complete) recanalization of the thrombosed intracranial sinuses was achieved in all patients. At a median radiographic follow-up of 7 months there was continued patency of all recanalized sinuses. Clinical follow-up was available on nine patients: modified Rankin score of 0 in four patients, 1 in three patients and 6 in two patients.
  
  
  CONCLUSIONS
  This series demonstrates the feasibility of performing mechanical thrombectomy as a first-line treatment for acute CVT. This technique facilitates the prompt restoration of intracranial venous outflow, which may result in rapid neurological and symptomatic improvement.
authors.affiliation: Norton Neuroscience Center, Norton Healthcare, Louisville, Kentucky, USA.
authors.forename: Shervin R
authors.initials: SR
authors.lastname: Dashti
authors.forename: Yin C
authors.initials: YC
authors.lastname: Hu
authors.forename: Tom
authors.initials: T
authors.lastname: Yao
authors.forename: David
authors.initials: D
authors.lastname: Fiorella
authors.forename: Alim P
authors.initials: AP
authors.lastname: Mitha
authors.forename: Felipe C
authors.initials: FC
authors.lastname: Albuquerque
authors.forename: Cameron G
authors.initials: CG
authors.lastname: McDougall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging* / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult