22. European Stroke Conference 590 © 2013 S. Karger AG, Basel Scientific Programme 18 Intracerebral/subarachnoid haemorrhage and venous diseases Endovascular Treatment of Cerebral Vein Thrombosis: a review of 16 cases M.C. Diogo1, A.A. Silva2, A. Azevedo3, A.P. Nunes4, R.F. Roque5, C. Sousa6, T. Baptista7, I. Fraga-ta8, C. Ribeiro9, J. Alcântara10, J. Reis11 Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL1, Centro Hospitalar de Lisboa Cen-tral, Lisbon, PORTUGAL2, Instituto Português de Oncologia, Lisbon, PORTUGAL3, Centro Hospi-talar de Lisboa Central, Lisbon, PORTUGAL4, Centro Hospitalar de Lisboa Central, Lisbon, POR-TUGAL5, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL6, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL7, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL8, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL9, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL10, Centro Hospitalar de Lisboa Central, Lisbon, PORTUGAL11 Background: Cerebral Venous Thrombosis (CVT) is a potentially fatal condition that remains a di-agnostic and therapeutic challenge. Endovascular treatment (ET) may be an option when clinical evolution is unfavorable despite anticoagulation. Our aim was to evaluate venous recanalization and functional outcome in CVT patients submitted to ET. Methods: We retrospectively analysed all CVT patients treated with ET in our Hospital between October 2003 and December 2011. Pretreat-ment neurological status and imaging were assessed. The degree of repermeabilization was classi-fied as null, partial or complete. Functional outcome was considered good when modified Rankin Scale (mRS) score was ≤2 at discharge. Results: 16 patients were treated, 4 males, 12 females, with a median age of 39 years. All had neurological status deterioration despite hypocoagulation or a severe clinical presentation at admission (Glasgow Coma Scale ≤8). Five patients were treated with local chemical thrombolysis (alteplase) alone and 11 were submitted to concomitant mechan-ical thrombectomy. In one case stenting of the right lateral sinus was performed. Partial dural sinus repermeabilization was achieved in all patients. There were no serious complications related to the technique, including symptomatic intracranial bleeding (SIB). Two patients died as a consequence of disease progression. The mean hospitalization time was 18 days. At discharge there was a good functional outcome in 56% patients, with a mean mRS score of 2,3 in the surviving patients. Con-clusion: In selected CVT patients with severe presentation or progressive deterioration despite hypo-coagulation, ET led to partial venous repermeabilization with clinical and functional improvement in most cases. No cases of SIB were registered in our series. Randomized controlled trials are needed to confirm the efficacy and safety of this therapeutic approach.
Karger_ESC London_2013
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