Efficacy and safety of mechanical thrombectomy in cerebral venous sinus thrombosis: a literature review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Hongyan ¹ , CHEANG Tuckyun ² , SUN Xunsha ¹ , SHEN Cunzhou ¹ , WANG Haiyan ¹ , FENG Li ¹ ,  CHEN Ling ¹

1. Department of Neurological Intensive Care Unit, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R.China;
2. Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R.China;

Corresponding author：

CHEN Ling, Email: chenl2@mail.sysu.edu.cn

Keywords：

Cerebral venous sinus thrombosis; Mechanical thrombectomy; Endovascular therapy; Case report

DOI：

10.7507/1672-2531.201802032

Video：

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Objectives To review the efficacy and safety of mechanical thrombectomy in patients with cerebral venous sinus thrombosis (CVST).Methods We searched The Cochrane Library, PubMed, EBSCO, Web of Science, CBM, CNKI and VIP databases to collect studies on mechanical thrombectomy in CVST patients from inception to April, 2018. Two reviewers independently screened literature, extracted the data and qualitative analysis of the included studies.Results A total of 33 studies including 552 patients were included for data analysis. Specifically, 157 (30%) patients had a focal neurological deficit, 145 (28%) patients had a pretreatment intracerebral hemorrhage or infarct, and 152 (29%) patients were stuporous or comatose. Wire was the most commonly used device. Overall, 483 (88%) patients had good outcome, while 35 (6%) patients deceased. Moreover, 333 (65%) patients had complete recanalization, 148 (29%) patients had partial recanalization, and 14 (2.5%) patients had worsen or new intracranial hemorrhage.Conclusions The current evidence suggests that mechanical thrombectomy is reasonably safe in the majority of cases. Due to limited quality and quantity of included studies, more high quality studies are required to verify above studies.

Citation： ZHOU Hongyan, CHEANG Tuckyun, SUN Xunsha, SHEN Cunzhou, WANG Haiyan, FENG Li, CHEN Ling. Efficacy and safety of mechanical thrombectomy in cerebral venous sinus thrombosis: a literature review. Chinese Journal of Evidence-Based Medicine, 2019, 19(7): 836-843. doi: 10.7507/1672-2531.201802032 Copy

1.	中华医学会神经病学分会. 中国颅内静脉系统血栓形成诊断和治疗指南 2015. 中华神经科杂志, 2015, 48(10): 819-829.
2.	Coutinho JM, Zuurbier SM, Aramideh M, et al. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke, 2012, 43(12): 3375-3377.
3.	Coutinho JM, Zuurbier SM, Stam J. Declining mortality in cerebral venous thrombosis: a systematic review. Stroke, 2014, 45(5): 1338-1341.
4.	de Bruijn SF, Stam J. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke, 1999, 30(3): 484-488.
5.	Ferro JM, Canhao P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the international study on cerebral vein and dural sinus thrombosis (ISCVT). Stroke, 2004, 35(3): 664-670.
6.	Kalita J, Misra UK, Singh RK. Do the risk factors determine the severity and outcome of cerebral venous sinus thrombosis? Transl Stroke Res, 2018, 9(6): 575-581.
7.	Siddiqui FM, Dandapat S, Banerjee C, et al. Mechanical thrombectomy in cerebral venous thrombosis: systematic review of 185 cases. Stroke, 2015, 46(5): 1263-1268.
8.	Ilyas A, Chen CJ, Raper DM, et al. Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review. J Neurointerv Surg, 2017, 9(11): 1086-1092.
9.	Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
10.	Coutinho JM, van den Berg R, Zuurbier SM, et al. Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis. J Neurointerv Surg, 2013, 5(6): 621-622.
11.	Arauz A, Vargas-Gonzalez JC, Arguelles-Morales N, et al. Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy. J Neurol Neurosurg Psychiatry, 2016, 87(3): 247-251.
12.	Krajíčková D, Klzo L, Krajina A, et al. Cerebral venous sinus thrombosis. Clin Appl Thromb Hemost, 2016, 22(7): 665-672.
13.	Nyberg EM, Case D, Nagae LM, et al. The addition of endovascular intervention for dural venous sinus thrombosis: single-center experience and review of literature. J Stroke Cerebrovasc Dis, 2017, 26(10): 2240-2247.
14.	Coutinho JM, van den Berg R, Zuurbier SM, et al. Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis. J Neurointerv Surg, 2013, 5(6): 621-622.
15.	Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
16.	Coutinho JM, Middeldorp S, Stam J. Advances in the treatment of cerebral venous thrombosis. Curr Treat Options Neurol, 2014, 16(7): 299.
17.	Borhani HA, Mahmoodi M, Edgell RC, et al. Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review. Clin Appl Thromb Hemost, 2014, 20(5): 507-515.
18.	Dentali F, Squizzato A, Gianni M, et al. Safety of thrombolysis in cerebral venous thrombosis. A systematic review of the literature. Thromb Haemost, 2010, 104(5): 1055-1062.
19.	Ding H, Xie Y, Li L, et al. Clinical features of seizures after cerebral venous sinus thrombosis and its effect on outcome among Chinese Han population. Stroke Vasc Neurol, 2017, 2(4): 184-188.
20.	Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
21.	Siddiqui FM, Banerjee C, Zuurbier SM, et al. Mechanical thrombectomy versus intrasinus thrombolysis for cerebral venous sinus thrombosis: a non-randomized comparison. Interv Neuroradiol, 2014, 20(3): 336-344.
22.	Qureshi AI, Grigoryan M, Saleem MA, et al. Prolonged microcatheter-based local thrombolytic infusion as a salvage treatment after failed endovascular treatment for cerebral venous thrombosis: a multicenter experience. Neurocrit Care, 2018, 29(1): 54-61.
23.	Lee CW, Liu HM, Chen YF, et al. Suction thrombectomy after balloon maceration for dural venous sinus thrombosis. J Neurol Sci, 2016, 365: 76-81.
24.	Ma J, Shui S, Han X, et al. Mechanical thrombectomy with Solitaire AB stents for the treatment of intracranial venous sinus thrombosis. Acta Radiol, 2016, 57(12): 1524-1530.
25.	莫大鹏, 罗岗, 王伊龙, 等. 多途径介入治疗进展性颅内静窦血栓初步分析. 中国卒中杂志, 2016, 11(9): 764-768.
26.	Mokin M, Lopes DK, Binning MJ, et al. Endovascular treatment of cerebral venous thrombosis: contemporary multicenter experience. Interv Neuroradiol, 2015, 21(4): 520-526.
27.	徐光军, 庄献博, 姜桂生, 等. 血管内介入治疗重症产褥期颅内静脉窦血栓形成. 中华临床医师杂志 (电子版), 2015, 9(10): 1851-1855.
28.	邱修辉, 李光标, 陈光忠. 支架取栓碎栓在重症脑静脉窦血栓介入治疗中的应用分析. 赣南医学院学报, 2015, 35(2): 270-272.
29.	Zhen Y, Zhang N, He L, et al. Mechanical thrombectomy combined with recombinant tissue plasminogen activator thrombolysis in the venous sinus for the treatment of severe cerebral venous sinus thrombosis. Exp Ther Med, 2015, 9(3): 1080-1084.
30.	武国德, 李鑫, 张振昶, 等. 扩张球囊碎栓治疗脑静脉窦血栓的临床观察. 临床内科杂志, 2014, 31(1): 49-51.
31.	水少锋, 李腾飞, 郭栋, 等. 球囊扩张成型与取栓治疗颅内静脉窦血栓疗效分析. 中国实用神经疾病杂志, 2014, 17(18): 25-27.
32.	杨勇, 于临源. 颅内静脉窦血栓行血管内介入治疗的临床价值分析. 中国医药指南, 2013, 11(35): 98-99.
33.	盛柳青, 马廉亭, 杨铭, 等. 重症脑静脉窦血栓形成的超选择窦内置管和机械取栓、碎栓及溶栓治疗. 介入放射学杂志, 2013, 22(12): 969-971.
34.	高永开. 18 例脑静脉窦血栓溶栓介入治疗临床观察. 健康必读 (中旬刊), 2013, 12(7): 215-216.
35.	陈光忠, 曾少建, 詹升全, 等. 应用 Solitaire AB 支架机械取栓联合溶栓治疗颅内静脉窦血栓形成的疗效观察. 中国脑血管病杂志, 2013, 10(10): 523-527.
36.	Li G, Zeng X, Hussain M, et al. Safety and validity of mechanical thrombectomy and thrombolysis on severe cerebral venous sinus thrombosis. Neurosurgery, 2013, 72(5): 730-738, 730.
37.	Jankowitz BT, Bodily LM, Jumaa M, et al. Manual aspiration thrombectomy for cerebral venous sinus thrombosis. J Neurointerv Surg, 2013, 5(6): 534-538.
38.	武国德, 张振昶, 李鑫, 等. 血管内介入治疗脑静脉窦血栓形成的临床研究. 中国临床医学影像杂志, 2012, 23(7): 461-464.
39.	李强, 李宜云, 张全斌. 动静脉联合介入治疗颅内静脉窦血栓形成. 江苏医药, 2012, 38(4): 482-483.
40.	陈昱云, 谷震, 王磊, 等. 颅内静脉窦血栓的血管内介入治疗. 昆明医科大学学报, 2012, 33(12): 135-137, 151.
41.	谷有全, 刘宁, 陈军, 等. 介入治疗颅内静脉窦血栓形成的有效性及安全性. 兰州大学学报·医学版, 2011, 37(2): 55-59.
42.	冯雷, 冯光, 贺道华, 等. 尿激酶联合替罗非斑在颅内静脉窦血栓形成介入性治疗中的应用. 中华神经医学杂志, 2011, 10(10): 1031-1033.
43.	徐树彬, 梁志会, 崔进国, 等. 脑静脉窦血栓形成的介入治疗. 介入放射学杂志, 2009, 18(8): 572-575.
44.	岳炫烨, 秦碧勇, 周少华, 等. 血管内治疗重症颅内静脉窦血栓形成. 第二军医大学学报, 2008, 29(7): 853-855.
45.	涂小平, 李慎茂, 朱凤水, 等. 脑静脉窦血栓形成介入治疗的疗效评价. 宁夏医学院学报, 2008, 30(1): 40-42, 封 4.
46.	Zhang A, Collinson RL, Hurst RW, et al. Rheolytic thrombectomy for cerebral sinus thrombosis. Neurocrit Care, 2008, 9(1): 17-26.
47.	张强, 李慎茂, 吉训明, 等. 血管内介入治疗颅内静脉窦血栓形成. 介入放射学杂志, 2007, 16(5): 303-306.
48.	王铁刚, 刘增品, 赵林, 等. 脑静脉窦血栓形成的介入治疗. 临床荟萃, 2007, 22(12): 880-881.
49.	Tsai FY, Kostanian V, Rivera M, et al. Cerebral venous congestion as indication for thrombolytic treatment. Cardiovasc Intervent Radiol, 2007, 30(4): 675-687.
50.	于伟东, 史怀璋, 李杰, 等. 血管内介入治疗 15 例颅内静脉窦血栓形成. 中国急救医学, 2006, 26(8): 623-624.
51.	Soleau SW, Schmidt R, Stevens S, et al. Extensive experience with dural sinus thrombosis. Neurosurgery, 2003, 52(3): 534-544.
52.	Baker MD, Opatowsky MJ, Wilson JA, et al. Rheolytic catheter and thrombolysis of dural venous sinus thrombosis: a case series. Neurosurgery, 2001, 48(3): 487-494.

1. 中华医学会神经病学分会. 中国颅内静脉系统血栓形成诊断和治疗指南 2015. 中华神经科杂志, 2015, 48(10): 819-829.
2. Coutinho JM, Zuurbier SM, Aramideh M, et al. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke, 2012, 43(12): 3375-3377.
3. Coutinho JM, Zuurbier SM, Stam J. Declining mortality in cerebral venous thrombosis: a systematic review. Stroke, 2014, 45(5): 1338-1341.
4. de Bruijn SF, Stam J. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke, 1999, 30(3): 484-488.
5. Ferro JM, Canhao P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the international study on cerebral vein and dural sinus thrombosis (ISCVT). Stroke, 2004, 35(3): 664-670.
6. Kalita J, Misra UK, Singh RK. Do the risk factors determine the severity and outcome of cerebral venous sinus thrombosis? Transl Stroke Res, 2018, 9(6): 575-581.
7. Siddiqui FM, Dandapat S, Banerjee C, et al. Mechanical thrombectomy in cerebral venous thrombosis: systematic review of 185 cases. Stroke, 2015, 46(5): 1263-1268.
8. Ilyas A, Chen CJ, Raper DM, et al. Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review. J Neurointerv Surg, 2017, 9(11): 1086-1092.
9. Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
10. Coutinho JM, van den Berg R, Zuurbier SM, et al. Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis. J Neurointerv Surg, 2013, 5(6): 621-622.
11. Arauz A, Vargas-Gonzalez JC, Arguelles-Morales N, et al. Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy. J Neurol Neurosurg Psychiatry, 2016, 87(3): 247-251.
12. Krajíčková D, Klzo L, Krajina A, et al. Cerebral venous sinus thrombosis. Clin Appl Thromb Hemost, 2016, 22(7): 665-672.
13. Nyberg EM, Case D, Nagae LM, et al. The addition of endovascular intervention for dural venous sinus thrombosis: single-center experience and review of literature. J Stroke Cerebrovasc Dis, 2017, 26(10): 2240-2247.
14. Coutinho JM, van den Berg R, Zuurbier SM, et al. Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis. J Neurointerv Surg, 2013, 5(6): 621-622.
15. Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
16. Coutinho JM, Middeldorp S, Stam J. Advances in the treatment of cerebral venous thrombosis. Curr Treat Options Neurol, 2014, 16(7): 299.
17. Borhani HA, Mahmoodi M, Edgell RC, et al. Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review. Clin Appl Thromb Hemost, 2014, 20(5): 507-515.
18. Dentali F, Squizzato A, Gianni M, et al. Safety of thrombolysis in cerebral venous thrombosis. A systematic review of the literature. Thromb Haemost, 2010, 104(5): 1055-1062.
19. Ding H, Xie Y, Li L, et al. Clinical features of seizures after cerebral venous sinus thrombosis and its effect on outcome among Chinese Han population. Stroke Vasc Neurol, 2017, 2(4): 184-188.
20. Dashti SR, Hu YC, Yao T, et al. Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device. J Neurointerv Surg, 2013, 5(1): 49-53.
21. Siddiqui FM, Banerjee C, Zuurbier SM, et al. Mechanical thrombectomy versus intrasinus thrombolysis for cerebral venous sinus thrombosis: a non-randomized comparison. Interv Neuroradiol, 2014, 20(3): 336-344.
22. Qureshi AI, Grigoryan M, Saleem MA, et al. Prolonged microcatheter-based local thrombolytic infusion as a salvage treatment after failed endovascular treatment for cerebral venous thrombosis: a multicenter experience. Neurocrit Care, 2018, 29(1): 54-61.
23. Lee CW, Liu HM, Chen YF, et al. Suction thrombectomy after balloon maceration for dural venous sinus thrombosis. J Neurol Sci, 2016, 365: 76-81.
24. Ma J, Shui S, Han X, et al. Mechanical thrombectomy with Solitaire AB stents for the treatment of intracranial venous sinus thrombosis. Acta Radiol, 2016, 57(12): 1524-1530.
25. 莫大鹏, 罗岗, 王伊龙, 等. 多途径介入治疗进展性颅内静窦血栓初步分析. 中国卒中杂志, 2016, 11(9): 764-768.
26. Mokin M, Lopes DK, Binning MJ, et al. Endovascular treatment of cerebral venous thrombosis: contemporary multicenter experience. Interv Neuroradiol, 2015, 21(4): 520-526.
27. 徐光军, 庄献博, 姜桂生, 等. 血管内介入治疗重症产褥期颅内静脉窦血栓形成. 中华临床医师杂志 (电子版), 2015, 9(10): 1851-1855.
28. 邱修辉, 李光标, 陈光忠. 支架取栓碎栓在重症脑静脉窦血栓介入治疗中的应用分析. 赣南医学院学报, 2015, 35(2): 270-272.
29. Zhen Y, Zhang N, He L, et al. Mechanical thrombectomy combined with recombinant tissue plasminogen activator thrombolysis in the venous sinus for the treatment of severe cerebral venous sinus thrombosis. Exp Ther Med, 2015, 9(3): 1080-1084.
30. 武国德, 李鑫, 张振昶, 等. 扩张球囊碎栓治疗脑静脉窦血栓的临床观察. 临床内科杂志, 2014, 31(1): 49-51.
31. 水少锋, 李腾飞, 郭栋, 等. 球囊扩张成型与取栓治疗颅内静脉窦血栓疗效分析. 中国实用神经疾病杂志, 2014, 17(18): 25-27.
32. 杨勇, 于临源. 颅内静脉窦血栓行血管内介入治疗的临床价值分析. 中国医药指南, 2013, 11(35): 98-99.
33. 盛柳青, 马廉亭, 杨铭, 等. 重症脑静脉窦血栓形成的超选择窦内置管和机械取栓、碎栓及溶栓治疗. 介入放射学杂志, 2013, 22(12): 969-971.
34. 高永开. 18 例脑静脉窦血栓溶栓介入治疗临床观察. 健康必读 (中旬刊), 2013, 12(7): 215-216.
35. 陈光忠, 曾少建, 詹升全, 等. 应用 Solitaire AB 支架机械取栓联合溶栓治疗颅内静脉窦血栓形成的疗效观察. 中国脑血管病杂志, 2013, 10(10): 523-527.
36. Li G, Zeng X, Hussain M, et al. Safety and validity of mechanical thrombectomy and thrombolysis on severe cerebral venous sinus thrombosis. Neurosurgery, 2013, 72(5): 730-738, 730.
37. Jankowitz BT, Bodily LM, Jumaa M, et al. Manual aspiration thrombectomy for cerebral venous sinus thrombosis. J Neurointerv Surg, 2013, 5(6): 534-538.
38. 武国德, 张振昶, 李鑫, 等. 血管内介入治疗脑静脉窦血栓形成的临床研究. 中国临床医学影像杂志, 2012, 23(7): 461-464.
39. 李强, 李宜云, 张全斌. 动静脉联合介入治疗颅内静脉窦血栓形成. 江苏医药, 2012, 38(4): 482-483.
40. 陈昱云, 谷震, 王磊, 等. 颅内静脉窦血栓的血管内介入治疗. 昆明医科大学学报, 2012, 33(12): 135-137, 151.
41. 谷有全, 刘宁, 陈军, 等. 介入治疗颅内静脉窦血栓形成的有效性及安全性. 兰州大学学报·医学版, 2011, 37(2): 55-59.
42. 冯雷, 冯光, 贺道华, 等. 尿激酶联合替罗非斑在颅内静脉窦血栓形成介入性治疗中的应用. 中华神经医学杂志, 2011, 10(10): 1031-1033.
43. 徐树彬, 梁志会, 崔进国, 等. 脑静脉窦血栓形成的介入治疗. 介入放射学杂志, 2009, 18(8): 572-575.
44. 岳炫烨, 秦碧勇, 周少华, 等. 血管内治疗重症颅内静脉窦血栓形成. 第二军医大学学报, 2008, 29(7): 853-855.
45. 涂小平, 李慎茂, 朱凤水, 等. 脑静脉窦血栓形成介入治疗的疗效评价. 宁夏医学院学报, 2008, 30(1): 40-42, 封 4.
46. Zhang A, Collinson RL, Hurst RW, et al. Rheolytic thrombectomy for cerebral sinus thrombosis. Neurocrit Care, 2008, 9(1): 17-26.
47. 张强, 李慎茂, 吉训明, 等. 血管内介入治疗颅内静脉窦血栓形成. 介入放射学杂志, 2007, 16(5): 303-306.
48. 王铁刚, 刘增品, 赵林, 等. 脑静脉窦血栓形成的介入治疗. 临床荟萃, 2007, 22(12): 880-881.
49. Tsai FY, Kostanian V, Rivera M, et al. Cerebral venous congestion as indication for thrombolytic treatment. Cardiovasc Intervent Radiol, 2007, 30(4): 675-687.
50. 于伟东, 史怀璋, 李杰, 等. 血管内介入治疗 15 例颅内静脉窦血栓形成. 中国急救医学, 2006, 26(8): 623-624.
51. Soleau SW, Schmidt R, Stevens S, et al. Extensive experience with dural sinus thrombosis. Neurosurgery, 2003, 52(3): 534-544.
52. Baker MD, Opatowsky MJ, Wilson JA, et al. Rheolytic catheter and thrombolysis of dural venous sinus thrombosis: a case series. Neurosurgery, 2001, 48(3): 487-494.

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