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.	中華醫學會神經病學分會. 中國顱內靜脈系統血栓形成診斷和治療指南 2015. 中華神經科雜志, 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.	Krají?ková 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.	莫大鵬, 羅崗, 王伊龍, 等. 多途徑介入治療進展性顱內靜竇血栓初步分析. 中國卒中雜志, 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.	徐光軍, 莊獻博, 姜桂生, 等. 血管內介入治療重癥產褥期顱內靜脈竇血栓形成. 中華臨床醫師雜志 (電子版), 2015, 9(10): 1851-1855.
28.	邱修輝, 李光標, 陳光忠. 支架取栓碎栓在重癥腦靜脈竇血栓介入治療中的應用分析. 贛南醫學院學報, 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.	武國德, 李鑫, 張振昶, 等. 擴張球囊碎栓治療腦靜脈竇血栓的臨床觀察. 臨床內科雜志, 2014, 31(1): 49-51.
31.	水少鋒, 李騰飛, 郭棟, 等. 球囊擴張成型與取栓治療顱內靜脈竇血栓療效分析. 中國實用神經疾病雜志, 2014, 17(18): 25-27.
32.	楊勇, 于臨源. 顱內靜脈竇血栓行血管內介入治療的臨床價值分析. 中國醫藥指南, 2013, 11(35): 98-99.
33.	盛柳青, 馬廉亭, 楊銘, 等. 重癥腦靜脈竇血栓形成的超選擇竇內置管和機械取栓、碎栓及溶栓治療. 介入放射學雜志, 2013, 22(12): 969-971.
34.	高永開. 18 例腦靜脈竇血栓溶栓介入治療臨床觀察. 健康必讀 (中旬刊), 2013, 12(7): 215-216.
35.	陳光忠, 曾少建, 詹升全, 等. 應用 Solitaire AB 支架機械取栓聯合溶栓治療顱內靜脈竇血栓形成的療效觀察. 中國腦血管病雜志, 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.	武國德, 張振昶, 李鑫, 等. 血管內介入治療腦靜脈竇血栓形成的臨床研究. 中國臨床醫學影像雜志, 2012, 23(7): 461-464.
39.	李強, 李宜云, 張全斌. 動靜脈聯合介入治療顱內靜脈竇血栓形成. 江蘇醫藥, 2012, 38(4): 482-483.
40.	陳昱云, 谷震, 王磊, 等. 顱內靜脈竇血栓的血管內介入治療. 昆明醫科大學學報, 2012, 33(12): 135-137, 151.
41.	谷有全, 劉寧, 陳軍, 等. 介入治療顱內靜脈竇血栓形成的有效性及安全性. 蘭州大學學報·醫學版, 2011, 37(2): 55-59.
42.	馮雷, 馮光, 賀道華, 等. 尿激酶聯合替羅非斑在顱內靜脈竇血栓形成介入性治療中的應用. 中華神經醫學雜志, 2011, 10(10): 1031-1033.
43.	徐樹彬, 梁志會, 崔進國, 等. 腦靜脈竇血栓形成的介入治療. 介入放射學雜志, 2009, 18(8): 572-575.
44.	岳炫燁, 秦碧勇, 周少華, 等. 血管內治療重癥顱內靜脈竇血栓形成. 第二軍醫大學學報, 2008, 29(7): 853-855.
45.	涂小平, 李慎茂, 朱鳳水, 等. 腦靜脈竇血栓形成介入治療的療效評價. 寧夏醫學院學報, 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.	張強, 李慎茂, 吉訓明, 等. 血管內介入治療顱內靜脈竇血栓形成. 介入放射學雜志, 2007, 16(5): 303-306.
48.	王鐵剛, 劉增品, 趙林, 等. 腦靜脈竇血栓形成的介入治療. 臨床薈萃, 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.	于偉東, 史懷璋, 李杰, 等. 血管內介入治療 15 例顱內靜脈竇血栓形成. 中國急救醫學, 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. 中華醫學會神經病學分會. 中國顱內靜脈系統血栓形成診斷和治療指南 2015. 中華神經科雜志, 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. Krají?ková 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. 莫大鵬, 羅崗, 王伊龍, 等. 多途徑介入治療進展性顱內靜竇血栓初步分析. 中國卒中雜志, 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. 徐光軍, 莊獻博, 姜桂生, 等. 血管內介入治療重癥產褥期顱內靜脈竇血栓形成. 中華臨床醫師雜志 (電子版), 2015, 9(10): 1851-1855.
28. 邱修輝, 李光標, 陳光忠. 支架取栓碎栓在重癥腦靜脈竇血栓介入治療中的應用分析. 贛南醫學院學報, 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. 武國德, 李鑫, 張振昶, 等. 擴張球囊碎栓治療腦靜脈竇血栓的臨床觀察. 臨床內科雜志, 2014, 31(1): 49-51.
31. 水少鋒, 李騰飛, 郭棟, 等. 球囊擴張成型與取栓治療顱內靜脈竇血栓療效分析. 中國實用神經疾病雜志, 2014, 17(18): 25-27.
32. 楊勇, 于臨源. 顱內靜脈竇血栓行血管內介入治療的臨床價值分析. 中國醫藥指南, 2013, 11(35): 98-99.
33. 盛柳青, 馬廉亭, 楊銘, 等. 重癥腦靜脈竇血栓形成的超選擇竇內置管和機械取栓、碎栓及溶栓治療. 介入放射學雜志, 2013, 22(12): 969-971.
34. 高永開. 18 例腦靜脈竇血栓溶栓介入治療臨床觀察. 健康必讀 (中旬刊), 2013, 12(7): 215-216.
35. 陳光忠, 曾少建, 詹升全, 等. 應用 Solitaire AB 支架機械取栓聯合溶栓治療顱內靜脈竇血栓形成的療效觀察. 中國腦血管病雜志, 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. 武國德, 張振昶, 李鑫, 等. 血管內介入治療腦靜脈竇血栓形成的臨床研究. 中國臨床醫學影像雜志, 2012, 23(7): 461-464.
39. 李強, 李宜云, 張全斌. 動靜脈聯合介入治療顱內靜脈竇血栓形成. 江蘇醫藥, 2012, 38(4): 482-483.
40. 陳昱云, 谷震, 王磊, 等. 顱內靜脈竇血栓的血管內介入治療. 昆明醫科大學學報, 2012, 33(12): 135-137, 151.
41. 谷有全, 劉寧, 陳軍, 等. 介入治療顱內靜脈竇血栓形成的有效性及安全性. 蘭州大學學報·醫學版, 2011, 37(2): 55-59.
42. 馮雷, 馮光, 賀道華, 等. 尿激酶聯合替羅非斑在顱內靜脈竇血栓形成介入性治療中的應用. 中華神經醫學雜志, 2011, 10(10): 1031-1033.
43. 徐樹彬, 梁志會, 崔進國, 等. 腦靜脈竇血栓形成的介入治療. 介入放射學雜志, 2009, 18(8): 572-575.
44. 岳炫燁, 秦碧勇, 周少華, 等. 血管內治療重癥顱內靜脈竇血栓形成. 第二軍醫大學學報, 2008, 29(7): 853-855.
45. 涂小平, 李慎茂, 朱鳳水, 等. 腦靜脈竇血栓形成介入治療的療效評價. 寧夏醫學院學報, 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. 張強, 李慎茂, 吉訓明, 等. 血管內介入治療顱內靜脈竇血栓形成. 介入放射學雜志, 2007, 16(5): 303-306.
48. 王鐵剛, 劉增品, 趙林, 等. 腦靜脈竇血栓形成的介入治療. 臨床薈萃, 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. 于偉東, 史懷璋, 李杰, 等. 血管內介入治療 15 例顱內靜脈竇血栓形成. 中國急救醫學, 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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