title: Suction thrombectomy after balloon maceration for dural venous sinus thrombosis.
abstract: OBJECTIVE
  To introduce the combination of suction thrombectomy (ST) and balloon maceration (BM) for the management of dural venous sinus thrombosis (DVST).
  
  
  METHODS
  Ten consecutive patients (average age, 53±15years; range, 30 to 73years) with DVST treated by ST after BM were evaluated including location of DVST, imaging presentation, procedural findings, and 3-month modified Rankin scale (mRS).
  
  
  RESULTS
  All 10 patients had evidence of venous infarct on MR or CT. In addition, seven patients had intracerebral hemorrhage (ICH), one had subarachnoid hemorrhage (SAH), and one had both ICH and SAH. More than one sinus was involved in nine patients. ST after BM was technically successful in all patients, and angiographic relief of venous congestion and good outcome (3-month mRS 0 or 1) was achieved in eight patients (80%). The average procedural time was 73.5±24.7min. Two patients who were in coma status had negative outcomes, and one had a known chronic thrombotic segment refractory to treatment. No recurrent thrombosis of recanalized sinus was found on follow-up MR venography in six patients and CT venography in two patients.
  
  
  CONCLUSIONS
  BM followed by ST is a promising technique for the treatment of acute DVST.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Medical Imaging and Radiology, Hospital and Medical College, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Chung-Wei
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Medical Imaging and Radiology, Hospital and Medical College, National Taiwan University, Taipei, Taiwan, ROC. Electronic address: hmliu@ntu.edu.tw.
authors.forename: Hon-Man
authors.initials: HM
authors.lastname: Liu
authors.affiliation: Department of Medical Imaging and Radiology, Hospital and Medical College, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Ya-Fang
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging and Radiology, Hospital and Medical College, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Yen-Heng
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC.
authors.forename: Jaw-Lin
authors.initials: JL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010690:Phlebography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013396:Suction; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Balloon maceration; Dural venous sinus thrombosis; Suction thrombectomy