Efficacy of systemic anticoagulation combined with endovascular interventional therapy for cerebral venous sinus thrombosis
10.3969/j.issn.1672-5921.2017.11.008
- VernacularTitle:全身抗凝联合血管内介入多种方式治疗颅内静脉窦血栓的疗效
- Author:
Penghao ZHAO
1
;
Cunhe ZHOU
;
Jianghua YU
;
Xudong SU
;
Jiao WANG
;
Zengpin LIU
Author Information
1. 河北医科大学第二医院神经内科
- Keywords:
Cerebral venous sinus thrombosis;
Interventional therapy;
Urokinase;
Anticoagulation
- From:
Chinese Journal of Cerebrovascular Diseases
2017;14(11):594-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of treatment of intracranial venous sinus thrombosis using systemic anticoagulation combined with endovascular intervention.Methods From May 2014 to January 2017,the clinical data of 52 patients with cerebral venous sinus thrombosis diagnosed with DSA and treated with micro catheter thrombolysis at the Department of Neurology,the Second Hospital of Hebei Medical University were analyzed retrospective.The microcatheters were indwelled for 3-14 d.The dosage of urokinase ranged from 10-20 thousand U/h,13 patients were also treated with balloon dilatation,and 1 was also treated with stent-assisted treatment.The results of imaging data and 6-month telephone follow-up were analyzed.The prognosis was evaluated with the modified Rankin scale (mRS) and National Institutes of Health Stroke Scale (NIHSS).Results In 52 patients admitted to hospital,the whole brain DSA showed sagittal sinus thrombosis in 34 cases,transverse-sigmoid sinus transitional zone thrombosis in 31 cases,inferior sagittal sinus thrombosis in 2 cases,straight sinus thrombosis in 3 cases,and cortical vein thrombosis in 14 cases.Angiography before discharge showed complete patency of the venous sinus in 9 cases,most patency in 42 cases,partial patency in 1 cases,the symptoms were relieved,and neurological function scores were improved at discharge in 48 cases.There were no obvious changes in 3 cases,and 1 case aggravated.The mRS and NIHSS scores before and after treatment were compared.The difference was statistically significant (Z =5.45 and 3.03 respectively,all P ＜ 0.05).Forty-eight patients were followed up for 6 months by telephone,no symptoms related to venous sinus thrombosis were found.Three patients died,and 1 died of traumatic intracranial hemorrhage.Conclusions Endovascular intervention is an effective and safe treatment for intracranial venous sinus thrombosis.It can be used as an alternative treatment scheme of internal medicine for patients of ineffective anticoagulation.
