Advertisement

Neuroradiology

, Volume 61, Issue 8, pp 845–846 | Cite as

Letter regarding “Combined aspiration thrombectomy and continuous intrasinus thrombolysis for cerebral venous sinus thrombosis: technical note and case series”

  • Samuele Cioni
  • Tommaso CasseriEmail author
  • Ignazio M. Vallone
  • Paola Gennari
  • Daniele G. Romano
  • Sara Leonini
  • Maurizio Acampa
  • Rossana Tassi
  • Giuseppe Martini
  • Sandra Bracco
Letter to the Editor
  • 32 Downloads

Dear Editor-in-Chief,

We read with great interest the report by Dr. Tsang and colleagues [1] about endovascular treatment of six cases of medical refractory acute cerebral venous sinus thrombosis (CVST). Authors describe aspiration thrombectomy with new-generation large bore catheters followed by continuous local thrombolytic infusion as a safe and effective salvage treatment.

So far, multicenter observational and experimental studies [2] assessed the contraindication to mechanical trombectomy in low-risk patients; however, it is not clear how to manage high-risk ones, who usually do not benefit from medical anticoagulation alone.

We report two cases, a 46-year-old female and a 61-year-old male recently admitted at our Institution because of acute CVST with a large clot burden, multiple sinuses involved, and acute parenchymal hematoma. Continuous endovenous heparin administration was promptly started. Agreeing with Tsang, I and my co-authors decided a more aggressive management without...

Notes

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Tsang ACO, Hwang AC, Chiu RHY, Chan DYC, Tsang FCP, Ho WS, Lee R, Leung GKK, Lui WM (2018) Combined aspiration thrombectomy and continuous intrasinus thrombolysis for cerebral venous sinus thrombosis: technical note and case series. Neuroradiology 60(10):1093–1096CrossRefGoogle Scholar
  2. 2.
    Coutinho JM, Ferro JM, Zuurbier SM, Canhão P, Crassard I, Majoie CB, Reekers JA et al (2013) Thrombolysis or anticoagulation for cerebral venous thrombosis: rationale and design of the TO-ACT trial. Int J Stroke 8(2):135–140CrossRefGoogle Scholar
  3. 3.
    Ma J, Shui S, Han X, Guo D, Li TF, Yan L (2016) Mechanical thrombectomy with Solitaire AB stents for the treatment of intracranial venous sinus thrombosis. Acta Radiol 57:1524–1530CrossRefGoogle Scholar
  4. 4.
    Lozano-Ros A, Luque-Buzo E, Garcìa-Pastor A, Castro-Reyes E, Dìaz-Otero F, Vazquez-Alen P et al (2016) Endovascular treatment of cerebral venous sinus thrombosis (CVST): is a complete racanalization required for a good clinical outcome? J Neuroradiol 43(1):51–54CrossRefGoogle Scholar
  5. 5.
    Dentali F, Squizzato A, Gianni M, De Lodovici ML, Venco A, Panciaroni M et al (2010) Safety of thrombolysis in cerebral venous thrombosis. A systematic review of the literature. Thromb Haemost 104(5):1055–1062Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Samuele Cioni
    • 1
  • Tommaso Casseri
    • 1
    Email author
  • Ignazio M. Vallone
    • 1
  • Paola Gennari
    • 1
  • Daniele G. Romano
    • 2
  • Sara Leonini
    • 1
  • Maurizio Acampa
    • 3
  • Rossana Tassi
    • 3
  • Giuseppe Martini
    • 3
  • Sandra Bracco
    • 1
  1. 1.Unit of Neuroimaging and Neurointervention (NINT)Azienda Ospedaliera e Universitaria SeneseSienaItaly
  2. 2.Neuroradiology UnitOspedale San Giovanni di Dio e Ruggi d’AragonaSalernoItaly
  3. 3.Stroke UnitAzienda Ospedaliera e Universitaria SeneseSienaItaly

Personalised recommendations