Application of a rheolytic thrombectomy device in the treatment of dural sinus thrombosis: A new technique

We present a novel application of a transvascular rheolytic thrombectomy sy stem in the treatment of symptomatic dural sinus thrombosis in a 54-year-ol d woman with somnolence and left-sided weakness. The diagnosis of bilateral transverse and superior sagittal sinus thrombosis was made and the patient was treated with anticoagulant therapy. After an initial period of improve ment, she became comatose and hemiplegic 8 days after presentation, After e xcluding intracerebral hemorrhage by MR imaging, we performed angiography a nd transfemoral venous thrombolysis with a hydrodynamic thrombectomy cathet er, followed by intrasinus urokinase thrombolytic therapy over the course o f 2 days. This technique resulted in dramatic sinus thrombolysis and near t otal neurologic recovery. Six months after treatment, the patient showed mi ld cognitive impairment and no focal neurologic deficit. Our preliminary ex perience suggests that this technique may play a significant role in the en dovascular treatment of this potentially devastating disease.