Intrasinus Thrombolysis for Cerebral Venous Sinus Thrombosis: Single-Center Experience
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Intrasinus Thrombolysis for Cerebral Venous Sinus Thrombosis: Single-Center Experience
Xinbin Guo,* Jiachen Sun, Xiaoke Lu and Sheng Guan*
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzou, China
Objective: The purpose of this research was to study the safety and efficacy of intrasinus thrombolysis in patients with cerebral venous thrombosis unresponsive to conventional heparin therapy.
Methods: A total of 156 CVST patients were treated using interventional thrombolysis in our center from January 2010 to June 2018. Clinical data, including duration of symptoms, indications and outcome of IST were retrieved, and outcomes were analyzed. DSA or MRV was used to assess the recanalization after thrombolysis. mRS was used to evaluate the outcome at admission, discharge, and follow-up.
Results: 91.38% of patients obtained functional independence (mRS 0-2). The mRS score was 0-2 in 120 patients (76.92%, 120/156) at the time of discharge. Seven patients succumbed during hospitalization. MRV extension was performed in 149 patients, and the results showed that the venous sinus of 112 patients (75.17%) was completely recanalized, and it was partially recanalized in 28 patients (18.79%) and nine patients (6.04%) had no recanalization at the time of discharge. In total, 116 patients were followed up for at least 6 months, 89 patients (76.72%) were completely recanalized, 21 patients (18.1%) were partially recanalized, and six patients (5.17%) were not recanalized.
Conclusion: IST may be more effective than systemic heparin anticoagulation in moribund and unresponsive patients despite the risk of hemorrhage. Large randomized controlled trials are required to further evaluate this issue.
Keywords: cerebral venous sinus thrombosis, intrasinus thrombolysis, safety, validity, anticoagulant
OPEN ACCESS
Edited by:
Sunil Sheth,
University of Texas Health Science Center at Houston, United States
Reviewed by:
Hans Kamal,
University of Texas Health Science Center at Houston, United States
Jazba Soomro,
Texas Stroke Institute, United States
*Correspondence:
Xinbin Guo
gxb3906080@sina.com
Sheng Guan
gsradio@126.com
Specialty section:
This article was submitted to Endovascular and Interventional Neurology, a section of the journal Frontiers in Neurology
Received: 23 June 2019
Accepted: 24 October 2019
Published: 13 November 2019
Citation:
Guo X, Sun J, Lu X and Guan S (2019) Intrasinus Thrombolysis for Cerebral Venous Sinus Thrombosis: Single-Center Experience. Front. Neurol. 10:1185, doi: 10.3389/fneur.2019.01185
This work is released under the Creative Commons Attribution 4.0 International license, which allows free use, distribution, and creation of derivatives, so long as the license is unchanged and clearly noted, and the original author is attributed.
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