Keywords:
Interventional vascular, Neuroradiology brain, Artificial Intelligence, Catheter arteriography, Catheter venography, MR, Thrombolysis, Technical aspects, Catheters, Aneurysms, Blood, Embolism / Thrombosis
Authors:
L. S. P. Karanam, S. R. BADDAM, V. Pamidimukkala, R. Polavarapu; Guntur/IN
DOI:
10.26044/ecr2019/C-0622
Methods and materials
46 patients(22 males and 24 females )with age ranging from 19 years to 62 years, presented to us with cerebral venous thrombosis in severe clinical grade refractory to Medical management subsequently received in situ thrombolysis during a 5-year period (April 2013 to April 2018) were included in the study. The grading of CVT was done using the criteria proposed by INR,
King Edward Memorial Hospital (KEM),
Mumbai,
India (table 1).Tissue plasminogen activator (tpa) was used in all the patients. All procedures were performed on Axiom Artis Zee,
Siemens,
Germany.
Digital subtraction angiogram with late venous phase was done in all the patients.
6 French guiding catheter is placed in the jugular bulb.
Mechanical maceration of the clot is done with 0.038 glide wire (terumo) in all the cases.
Micro catheter (echelon,
progreat) over 0.014 wire was negotiated into the thrombosed sinus .Micro catheter injection confirmed the accurate position in the thrombus and 2mg bolus is then given.
tpa infusion was started at rate of 1 mg per hour and periodic check venograms were done .Infusion was continued until significant clinical improvement or partial recanalisation of the sinus with good outflow is seen. The lytic agent was infused into the sinus via the micro catheter.
Data regarding demographic,
clinical,
and radio logic features were analyzed in all the patients.