2.Efficacy of systemic anticoagulation combined with endovascular interventional therapy for cerebral venous sinus thrombosis
Penghao ZHAO ; Cunhe ZHOU ; Jianghua YU ; Xudong SU ; Jiao WANG ; Zengpin LIU
Chinese Journal of Cerebrovascular Diseases 2017;14(11):594-598
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.
4.Clinical analysis of submaximal balloon dilatation combined with Enterprise stent in treatment of complex symptomatic intracranial atherosclerotic stenosis
Xin LI ; Jianghua YU ; Cunhe ZHOU ; Xudong SU ; Ruiqing CHEN ; Zengpin LIU
Chinese Journal of Neuromedicine 2019;18(8):801-806
Objective To observe the safety and efficacy of submaximal balloon dilation combined with Enterprise stent in the treatment of complex symptomatic intracranial atherosclerotic stenosis (ICAS).Methods Clinical data of 70 patients with complicated symptomatic ICAS treated in our hospital from February 2015 to September 2018 were retrospectively analyzed, and any stroke (cerebral infarction or transient ischemic attack [TIA] or cerebral hemorrhage), or death within 30 days were observed, as well as the recurrence of ischemic events and stent restenosis in the vascular supply area after 30 d of follow-up.Results Among the 70 patients, the success rate of operation was 100%; the preoperative stenosis rate was (81.4±10.2)% and the postoperative stenosis rate was (18.3±6.4)%, with significant difference (P<0.05). Perioperative complications occurred in 4 patients (5.7%): two were subacute thrombosis in stent two d after operation; one had cerebral hemorrhage 10 h after operation, and one had perforator artery occlusion leading to pontine infarction. Nine patients (14.5%) had restenosis in stent during the follow-up period; symptomatic restenosis occurred in 3 (4.8%).Conclusion It is safe and effective to treat complex symptomatic ICAS with submaximal balloon dilatation combined with Enterprise stent, which can obviously decrease the incidences of postoperative complications and recent in-stent restenosis.