我们介绍了一例利用Penumbra的Indigo抽吸系统成功进行脑静脉窦血栓形成的血管内血栓切除术(PenumbraInc.,阿拉米达广场,CA),一种具有大腔(IndigoSystemCAT7,7F)导管的微创系统,主要用于去除涉及外周动脉和静脉系统的血栓栓塞。一名30岁的女性出现癫痫发作和局灶性神经功能缺损,被发现患有左侧颞叶后出血性梗塞,继发于广泛的脑静脉窦血栓形成,从左侧横窦延伸到同侧颈内球部。我们考虑了癫痫发作的合并,运动赤字,出血性梗塞的高风险特征是对治疗性抗凝药物的标准药物治疗反应不佳。因此,除肝素输注抗凝治疗外,我们还使用上述装置进行了机械静脉血栓切除术.这种联合疗法在技术上成功地对所涉及的鼻窦进行了影像学再通,并在随访中获得了出色的功能结果。这个案例表明,这个可跟踪的,无创伤,大口径系统在脑静脉系统中是安全有效的,允许接近完全的血栓清除。
We present a
case of successful endovascular thrombectomy of cerebral venous sinus thrombosis utilizing Penumbra\'s Indigo Aspiration System (Penumbra Inc., Place Alameda, CA), a minimally invasive system with a large-lumen (Indigo System CAT7, 7F) catheter predominantly used for the removal of thromboembolism involving the peripheral arterial and venous systems. A 30-year-old female presented with a seizure and focal neurological deficits and was found to have a left posterior temporal lobe hemorrhagic infarct secondary to an extensive cerebral venous sinus thrombosis extending from the left transverse sinus to the ipsilateral internal jugular bulb. We considered the combination of seizure, motor deficit, and hemorrhagic infarct high-risk features for poor response to standard medical therapy with therapeutic anticoagulation. Therefore, we performed a mechanical venous thrombectomy with the above device in addition to anticoagulation treatment with heparin infusion. This combination therapy resulted in a technically successful radiographic recanalization of the involved sinuses and an excellent functional outcome at follow-up. This
case demonstrates that this trackable, atraumatic, large-bore system was safe and efficacious in the cerebral venous system, permitting near-complete thrombus removal.