介入治疗颅内静脉窦血栓形成的有效性及安全性

Effectiveness and safety of endovascular treatment for intracranial venous sinus thrombosis

目的探讨介入治疗颅内静脉窦血栓形成的疗效和安全性。方法对12例临床抗凝治疗无效的颅内静脉窦血栓形成患者行介入治疗,全部患者均接受经静脉插管接触性溶栓联合机械性碎栓治疗,其中3例在接受经静脉途径溶栓后又接受了经动脉溶栓。术后继续抗凝治疗12月,随访12～24月,平均18月。结果12例患者的临床症状和体征均得到缓解或部分缓解,其中10例头痛消失,2例存在轻度头痛。所有患者腰椎穿刺脑脊液压力均恢复正常,未冉发生血栓形成和新的神经功能缺失症状。除了1例患者出现股静脉穿刺部位皮下渗血外,其余患者均未发生与操作相关的颅内或全身出血并发症。结论介入治疗颅内静脉窦血栓是安全、有效的治疗手段之一。

Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis.Methods 12 patients with intracranial venous sinus thrombosis were treated with endovascular management in individuation after they failed to respond to anticoagulant therapy.Intravenous thrombolysis and mechanical thrombus maceration were carried out in all but intravenous thrombolysis,mechanical thrombus maceration together with intra-arterial thrombolysis were employed in 3.After the treatment,the anticoagulant therapy continued for 12 months.The patients were followed up for 12～24 months（mean 18 months）. Results After the treatment,the clinical symptoms and signs were completely or partially relieved in all patients,including disappearance of headache（n=10）and relief of headache（n=2）. Lumbar puncture showed that the cerebrospinal fluid pressure returned to normal in all patients. Neither recurrence of thrombosis nor new symptom of neuralgic dysfunction was observed.No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation besides errhysis in subcutaneouly after venepuncture in one patient.Conclusion Endovascular treatment is one of the effective and safe ways for patients with intracranial venous sinus thrombosis.