重症颅内静脉窦血栓形成的血管内治疗

目的:探讨重症颅内静脉窦血栓形成(CVST)血管内介入治疗方法的选择及其疗效。方法:根据10例重症CVST患者的病情采用经静脉接触性溶栓术、机械性破栓术、静脉窦内支架置入术及动脉溶栓术中的1种或多种。结果:10例患者均采用经静脉接触性溶栓术,其中2例联用机械性破栓术,2例联用静脉窦内支架置入术,4例联用动脉溶栓术。术后仅1例出现血管内治疗相关并发症(脑内血肿)。出院时,10例患者GCS评分均达15分,临床症状均改善,闭塞的静脉窦均再通。平均随访12个月,所有患者腰穿压力均恢复正常,未出现血栓再形成和新的神经系统症状。结论:对重症CVST患者积极采用合理的血管内介入治疗是有效的。

Endovascular Treatment for Severe Cranial Venous Sinus Thrombosis

Objective:The ways of endovascular treatment for severe cranial venous sinus thrombosis and their effect and risks have been evaluated.Methods: Ten patients with severe cranial venous sinus thrombosis were treated by one or more following ways: transvenous thrombolysis,mechanical thrombus maceration,stenting,or intra-arterial thrombolysis.Results: Except one patient who experienced intra-cerebral hemorrhage and remained hemiparalytic,there was no complications occurred in other 9 patients related to endovascular treatments during and after the operation.No case died.At discharge,GCS in all patients was improved from average 11 before operation to 15 after operation.Clinical conditions improved satisfactory,and venous sinuses were recanalized.In a follow-up of average 12 months,the pressures of lumbar puncture were recovered in all patients.No new neurologic deficits was observed.Conclusion: Reasonably using endovascular treatments aggressively in patients with severe cranial venous sinus thrombosis is effective.