title: Endovascular treatment of cerebral venous thrombosis: Contemporary multicenter experience.
abstract: Endovascular therapy of cerebral venous thrombosis using modern approaches to intracranial recanalization, such as stent retrievers and aspiration thrombectomy, is not well described. We performed a retrospective review of data for consecutive patients with venous sinus thrombosis who underwent endovascular treatment between 1 January 2010 and 31 December 2013 at participating institutions. We identified a total of 13 patients with a diagnosis of cerebral venous thrombosis. The most frequently utilized type of endovascular intervention was the Penumbra aspiration system (Penumbra Inc., Alameda, California, USA) (nine cases), followed by local infusion of tissue plasminogen activator (bolus and/or drip in six cases) and stent retrievers (Solitaire FR (Covidien, Irvine, California, USA) in three cases and Trevo (Stryker, Kalamazoo, Michigan, USA) in one case). Overall, multimodality treatment (two or more different types of devices or approaches) was performed in 62% of cases. Follow-up data were available for 11 patients; of those, five had a favorable clinical outcome (defined as modified Rankin Scale score of 0-2) and three patients died. Various endovascular approaches are utilized in current clinical practice. A multimodal approach to endovascular therapy for the treatment of cerebral venous thrombosis resulted in partial or complete restoration of flow in all cases, yet the mortality rate of 27% indicates the need for improvement in recanalization strategies for this disorder.
authors.affiliation: Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences, and Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA.
authors.forename: Maxim
authors.initials: M
authors.lastname: Mokin
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, USA.
authors.forename: Demetrius K
authors.initials: DK
authors.lastname: Lopes
authors.affiliation: Capital Health, Trenton, USA.
authors.forename: Mandy J
authors.initials: MJ
authors.lastname: Binning
authors.affiliation: Capital Health, Trenton, USA.
authors.forename: Erol
authors.initials: E
authors.lastname: Veznedaroglu
authors.affiliation: Capital Health, Trenton, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Liebman
authors.affiliation: University of Tennessee Department of Neurosurgery/Semmes-Murphey Neurologic and Spine Institute, Memphis, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Arthur
authors.affiliation: University of Tennessee Department of Neurosurgery/Semmes-Murphey Neurologic and Spine Institute, Memphis, USA.
authors.forename: Vinodh T
authors.initials: VT
authors.lastname: Doss
authors.affiliation: Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences, and Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA.
authors.forename: Elad I
authors.initials: EI
authors.lastname: Levy
authors.affiliation: Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences, and Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA asiddiqui@ubns.com.
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015607:Stents; D013396:Suction; D017131:Thrombectomy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010959:Tissue Plasminogen Activator
keywords: Aspiration thrombectomy catheter; cerebral venous thrombosis; endovascular therapy; stent retriever