RESUMO
We present a young woman with rapidly progressive neurologic decline in the setting of malignant cerebral edema due to extensive superior sagittal sinus thrombosis and cortical venous thrombosis despite intravenous heparin administration. Complete revascularization of the occluded sinus was achieved using suction thrombectomy with the 5 max Penumbra catheter in combination with the Solitaire FR clot retrieval device. The successful endovascular treatment halted the progression of her cerebral edema, and the patient eventually had an excellent recovery after prolonged intensive medical therapy. To our knowledge, this is the first reported case describing such a combined mechanical approach for cerebral venous sinus thrombosis. The clot retrieval properties of the Solitaire device combined with direct aspiration via the newest generation Penumbra catheters may allow more rapid, safe and efficient revascularization than all previously reported endovascular treatments for this potentially devastating condition.
Assuntos
Trombose dos Seios Intracranianos/cirurgia , Trombectomia/instrumentação , Trombectomia/métodos , Adulto , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/cirurgia , Revascularização Cerebral/instrumentação , Revascularização Cerebral/métodos , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/cirurgia , Feminino , Humanos , Trombose dos Seios Intracranianos/diagnóstico por imagem , Sucção , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We present a young woman with rapidly progressive neurologic decline in the setting of malignant cerebral edema due to extensive superior sagittal sinus thrombosis and cortical venous thrombosis despite intravenous heparin administration. Complete revascularization of the occluded sinus was achieved using suction thrombectomy with the 5 max Penumbra catheter in combination with the Solitaire FR clot retrieval device. The successful endovascular treatment halted the progression of her cerebral edema, and the patient eventually had an excellent recovery after prolonged intensive medical therapy. To our knowledge, this is the first reported case describing such a combined mechanical approach for cerebral venous sinus thrombosis. The clot retrieval properties of the Solitaire device combined with direct aspiration via the newest generation Penumbra catheters may allow more rapid, safe and efficient revascularization than all previously reported endovascular treatments for this potentially devastating condition.
Assuntos
Trombose do Seio Sagital/cirurgia , Trombectomia/métodos , Adulto , Edema Encefálico/complicações , Feminino , Humanos , Trombose Intracraniana/complicações , Sucção/métodos , Resultado do TratamentoAssuntos
Angiografia Cerebral/métodos , Transtornos Cerebrovasculares/diagnóstico por imagem , Radiografia Intervencionista/métodos , Transtornos Cerebrovasculares/tratamento farmacológico , Transtornos Cerebrovasculares/cirurgia , Migração de Corpo Estranho/diagnóstico por imagem , Humanos , Achados Incidentais , StentsRESUMO
OBJECTIVE: This essay depicts recent advances of MDCT in the evaluation of aortic valvular disease. CONCLUSION: Aortic valvular disease can be assessed with current MDCT technology. The improved imaging characteristics of MDCT have significantly decreased artifacts traditionally seen with prosthetic aortic valves and enabled excellent visualization of valve function. Advances in ECG-gated MDCT technology offer the opportunity to evaluate a variety of aortic valvular abnormalities.
