Rheolytic catheter thrombectomy, balloon angioplasty, and direct recombinant tissue plasminogen activator thrombolysis of dural sinus thrombosis with preexisting hemorrhagic infarctions

AJNR Am J Neuroradiol. 2004 Nov-Dec;25(10):1807-11.

Abstract

We describe the case of a 28-year-old obtunded woman who presented with bilateral anterior parietal lobe cortical hemorrhages associated with thrombosis of the superior sagittal sinus, both transverse and sigmoid sinuses, and multiple cortical veins draining into the sagittal sinus. Initial heparin therapy was not effective. A combination of AngioJet rheolytic catheter thrombectomy, balloon angioplasty, and continuous direct superior sagittal sinus recombinant tissue plasminogen activator infusion led to venous recanalization with a successful clinical outcome, without worsening of the preexisting intracranial hemorrhages.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angioplasty, Balloon*
  • Cerebral Hemorrhage / complications
  • Cerebral Infarction / complications
  • Dura Mater*
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Phlebography
  • Recombinant Proteins / therapeutic use
  • Sinus Thrombosis, Intracranial / complications
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / therapy*
  • Thrombectomy / methods*
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator