Endovascular thrombolysis and stent angioplasty for obliteration in cerebral venous sinuses / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the experience of treating the obliteration of the cerebral venous sinus in 17 patients by using direct thrombolysis and stent angioplasty.</p><p><b>METHODS</b>All 17 patients with thrombosis and stenosis of the venous sinus were confirmed by digital subtraction angiography. Of these 3 patients had thrombosis in a single sinus and 14 had thrombosis in multiple sinuses. The circulating time was prolonged for over 13 seconds. The micro-catheter was preserved in the sinus for 5 days, followed by infusion of urokinase 1.5 million units and oral warfarin 3-5 mg each day. Stent angioplasty was done for 4 patients with obvious stenosis of the venous sinus detected by DSA after thrombosis.</p><p><b>RESULTS</b>After contact thrombosis and stent angioplasty in sinuses of the 17 patients, remarkable recanalization of obliterated sinuses was achieved. After treatment, intracranial hypertension pressure (ICP) returned to normal in 7 patients, and 8 thrombosis relapsed in different degree after 7 days. Anticoagulation was prescribed. Only 2 patients showed the ICP above 280 mm H(2)O. No obvious relapse was found in 15 patients during the follow-up for 3-60 months.</p><p><b>CONCLUSION</b>Our results demonstrated that successive thrombolysis and stent angioplasty for occlusion and thrombosis of the venous sinus are effective in promoting drainage of cerebral venous blood and rapidly decreasing ICP.</p>