颅内静脉窦狭窄及血栓形成的血管内治疗

Endovascular treatment of intracranial venous stenosis and thrombosis

目的:探讨经血管内途径治疗颅内静脉窦狭窄及血栓形成的疗效和安全性。方法:对9例(8例颅内静脉窦血栓形成,1例静脉窦狭窄)患者进行了包括经静脉接触性溶栓、机械性破栓、经颈动脉溶栓多途径联合血管内治疗及支架置入术。病人均有颅内静脉窦血栓形成的危险因素。术后积极治疗原发病,抗凝治疗6个月。术后随访1～6个月,平均4个月。结果:1例患者施行静脉窦狭窄支架置入术;8例患者接受了经静脉途径溶栓治疗,其中5例患者同时接受机械性血栓开通吸栓治疗,所有8例患者同时接受经颈动脉途径团注肝素治疗,尿激酶使用总量800000～2900000U,每例患者平均每天剂量低于1000000U。出院时,所有患者的狭窄或闭塞静脉窦均获得再通,临床症状改善,颅内压恢复。结论:血管内治疗是颅内静脉窦狭窄及血栓的安全、有效治疗手段。

Objective To discuss the curative effect and the risk of endovascular thrombolysis for intracranial venous thrombosis. Methods Nine patients with intracranial venous thromosis confirmed were treated with multiple modality endovascular thrombolysis including intravenous thrombolysis,mechanical thrombus maceration, intraarterial thrombolysis and stenting, After thromolysis,treatment aimed at the primary diseases was continued and warfarin was used for 6 months to anticoagulate. The patients were followed-up for one to six months ,averaged four months . Results All of the 9 patients ware underwent transvenors thrombolysis. Meanwhile,one of the patients was treated with stenting ,five of the patients were underwent mechanical thrombus maceration and 8 patients were underwent intraarterial thrombolysis. The infusion dose of urokinase was 800 000 to 2 900 000 IU, for every patient the averaging dosage of urokinase was less than I 000 000 IU perday. After treatment,the obliterative sinus venosuses of all patients were recanalized,the intracranial pressures were degraded or recovered to normal and all the ptients had improved neurologically. Conclusion Endovascular treatment is an effective and safe measurement for intracranial venous thrombosis.