Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

INTERVENTIONAL RADIOLOGY
Year
: 2017  |  Volume : 27  |  Issue : 1  |  Page : 82--87

Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis


Suraj Mammen1, Shyamkumar Nidugala Keshava1, Vinu Moses1, Sanjith Aaron2, Munawwar Ahmed1, George K Chiramel1, Sunithi E Mani1, Mathew Alexander2 
1 Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Shyamkumar Nidugala Keshava
Department of Radiology, Christian Medical College, Vellore, Tamil Nadu
India

Background: In dural venous sinus thrombosis (DVST), the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. Materials and Methods: Eight patients with magnetic resonance imaging (MRI)-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System®. In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. Results: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS), with 5/8 (62%) patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months), and there were no new neurological events during the follow-up period. Conclusion: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up.


How to cite this article:
Mammen S, Keshava SN, Moses V, Aaron S, Ahmed M, Chiramel GK, Mani SE, Alexander M. Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis.Indian J Radiol Imaging 2017;27:82-87


How to cite this URL:
Mammen S, Keshava SN, Moses V, Aaron S, Ahmed M, Chiramel GK, Mani SE, Alexander M. Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis. Indian J Radiol Imaging [serial online] 2017 [cited 2020 Apr 7 ];27:82-87
Available from: http://www.ijri.org/article.asp?issn=0971-3026;year=2017;volume=27;issue=1;spage=82;epage=87;aulast=Mammen;type=0