ISHIKAWA Tatsuya    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Stenting for acute cerebral venous sinus thrombosis in the superior sagittal sinus.
Journal	Formal name：Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Abbreviation：Interv Neuroradiol ISSN code：(1591-0199)1591-0199(Linking)
Domestic / Foregin	Foregin
Volume, Issue, Page	21(6),pp.719-23
Author and coauthor	Adachi Hidemitsu, Mineharu Yohei, Ishikawa Tatsuya, Imamura Hirotoshi, Yamamoto Shiro, Todo Kenichi, Yamagami Hiroshi, Sakai Nobuyuki
Authorship	2nd author
Publication date	2015/12
Summary	Endovascular treatment for superior sagittal sinus (SSS) thrombosis is not always successful because of difficult access and long thrombus lesions. We report the first two cases of patients with acute cerebral venous sinus thrombosis at the SSS that was not recanalized by anticoagulation, mechanical thrombectomy, or thrombolysis, but was successfully treated by stent placement. Case 1 was a 37-year-old woman with bilateral subdural hematomas. Digital subtraction angiography showed obstruction of the sinus from the SSS to the right transverse sinus. Recanalization was achieved by selective thrombolysis using urokinase followed by balloon angioplasty, but re-occlusion occurred on the next day of treatment. Repeated endovascular treatment including balloon angioplasty, thrombus aspiration and thrombolysis using recombinant tissue plasminogen activator failed to achieve recanalization. We thus placed intracranial stents in the SSS, which did achieve recanalization. Case 2 was a 69-year-old woman with a small infarction in the left parietal lobe. Digital subtraction angiography showed sinus obliteration from the SSS to the bilateral transverse sinuses. Recanalization was not achieved by balloon angioplasty, thrombus aspiration and selective thrombolysis. We thus placed intracranial stents in the SSS, which did achieve recanalization. Postoperative course was uneventful in both cases and venous sinus patency was confirmed by venography >1.5 years after treatment. When conventional endovascular strategies have been unsuccessful, placement of intracranial stents, which can easily gain access to the distal part of the SSS as compared with carotid stents, may be a useful treatment option for the acute sinus thrombosis in this region.
DOI	10.1177/1591019915609120
PMID	26494402