Safety and efficacy of the use of large bore intermediate suction catheters alone or in combination for the treatment of acute cerebral venous sinus thrombosis: A multicenter experience

Sudeepta Dandapat; Edgar A Samaniego; Viktor Szeder; Fazeel M Siddiqui; Gary R Duckwiler; Ume Kiddy; Waldo R Guerrero; Binbin Zheng; David Hasan; Colin Derdeyn; Santiago Ortega-Gutierrez

doi:10.1177/1591019919865957

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Safety and efficacy of the use of large bore intermediate suction catheters alone or in combination for the treatment of acute cerebral venous sinus thrombosis: A multicenter experience

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Safety and efficacy of the use of large bore intermediate suction catheters alone or in combination for the treatment of acute cerebral venous sinus thrombosis: A multicenter experience

Sudeepta Dandapat, Edgar A Samaniego, Viktor Szeder, Fazeel M Siddiqui, Gary R Duckwiler, Ume Kiddy, Waldo R Guerrero, Binbin Zheng, David Hasan, Colin Derdeyn, …

Interventional neuroradiology, Vol.26(1), pp.26-32

02/2020

DOI: 10.1177/1591019919865957

PMID: 31364456

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Abstract

Systemic anticoagulation is the standard treatment for cerebral venous sinus thrombosis (CVST). Several endovascular techniques have been described as salvage therapy for anticoagulation refractory CVST cases. We aim to evaluate the safety and feasibility of endovascular aspiration thrombectomy using the new generation, large bore suction catheters alone or in combination with stentriever devices for the treatment of CVST. We collected data on 16 consecutive patients with CVST who received endovascular aspiration thrombectomy at three large academic centers. Second generation reperfusion catheters were used as a large bore suction catheter and advanced to the affected sinus using a coaxial technique. Suction was performed using pump suction. At times, a stentriever was used as an anchor to facilitate advancing the suction catheter and to increase thrombectomy capabilities. Median decade of age was the 50s and nine patients were women. Fifty percent of the patients had multiple sinuses involved. All patients received systemic anticoagulation prior to endovascular aspiration thrombectomy. The most common reason to pursue endovascular aspiration thrombectomy in CVST patients was deterioration of initial clinical status (10/16). The mean time from admission to endovascular aspiration thrombectomy was 1.5 days (range 0-6 days). Good recanalization was obtained in all patients. There were no major peri-procedural complications. Most patients were discharged to either home or a rehabilitation facility. Endovascular aspiration treatment using large bore suction catheters for CVST is a safe and feasible approach for the treatment of anticoagulation refractory CVST. Heterogeneity of the clinical and radiological presentation requires further investigation to optimize patient selection before evaluating the efficacy of this technique in larger prospective studies.

Catheterization - methods

Humans

Middle Aged

Anticoagulants - therapeutic use

Male

Treatment Outcome

Thrombectomy - adverse effects

Academic Medical Centers

Sinus Thrombosis, Intracranial - diagnostic imaging

Reperfusion

Suction - adverse effects

Catheters - adverse effects

Thrombectomy - methods

Adolescent

Aged, 80 and over

Adult

Catheterization - adverse effects

Female

Sinus Thrombosis, Intracranial - surgery

Aged

Retrospective Studies

Suction - methods

Child

Stents

Details

Title: Subtitle: Safety and efficacy of the use of large bore intermediate suction catheters alone or in combination for the treatment of acute cerebral venous sinus thrombosis: A multicenter experience
Creators: Sudeepta Dandapat - Department of Radiology, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Edgar A Samaniego - Department of Neurosurgery, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Viktor Szeder - Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
Fazeel M Siddiqui - Department of Neurology, Southern Illinois University School of Medicine, Comprehensive Stroke Center, Springfield, IL, USA
Gary R Duckwiler - Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
Ume Kiddy - Department of Neurology, Southern Illinois University School of Medicine, Comprehensive Stroke Center, Springfield, IL, USA
Waldo R Guerrero - Department of Radiology, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Binbin Zheng - Department of Neurology, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
David Hasan - Department of Neurosurgery, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Colin Derdeyn - Department of Radiology, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Santiago Ortega-Gutierrez - Department of Neurosurgery, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Interventional neuroradiology, Vol.26(1), pp.26-32
DOI: 10.1177/1591019919865957
PMID: 31364456
NLM abbreviation: Interv Neuroradiol
ISSN: 1591-0199
eISSN: 2385-2011
Publisher: United States
Language: English
Date published: 02/2020
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984070642902771

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