Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients

BackgroundCerebral venous sinus thrombosis (CVST) is an unusual cause of stroke. Currently, standard anticoagulant therapy does not have satisfactory efficacy for treating some cases of hemorrhagic CVST. Therefore, we explored the efficacy and safety of the combination of sliding balloon-assisted th...

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Main Authors: Mingsi Zhang, Feixin Jiang, Qingyan Wen, Yiman Chen, Zhiquan Zhang, Min Zhang, Jianxin Zhong
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1519308/full
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author Mingsi Zhang
Feixin Jiang
Qingyan Wen
Yiman Chen
Zhiquan Zhang
Min Zhang
Jianxin Zhong
author_facet Mingsi Zhang
Feixin Jiang
Qingyan Wen
Yiman Chen
Zhiquan Zhang
Min Zhang
Jianxin Zhong
author_sort Mingsi Zhang
collection DOAJ
description BackgroundCerebral venous sinus thrombosis (CVST) is an unusual cause of stroke. Currently, standard anticoagulant therapy does not have satisfactory efficacy for treating some cases of hemorrhagic CVST. Therefore, we explored the efficacy and safety of the combination of sliding balloon-assisted thrombectomy with aspiration and intrasinus urokinase thrombolysis for the treatment of CVST patients with intracranial hemorrhage (ICH).MethodsWe retrospectively analyzed the clinical, imaging and follow-up data of 10 CVST patients with ICH who underwent sliding balloon-assisted thrombectomy combined with aspiration and intrasinus thrombolysis with urokinase from February 2022 to June 2023. Complete recanalization and partial recanalization in the cerebral venous sinus were defined as imaging outcomes, and the modified Rankin score (mRS) at the 3-month and 6-month follow-ups was used to evaluate clinical efficacy.ResultsA total of 10 CVST patients aged 18–68 years were enrolled, including 5 males. All of the patients was diagnosed with ICH by noncontrast CT and with thrombosis at 3 or more venous sinuses by digital subtraction angiography (DSA). After treatment, complete recanalization was achieved in 6 patients, and partial recanalization was achieved in 4 patients. At the 3- and 6-month follow-up, all 10 patients showed neurological independence (mRS score ≤ 2), without any signs of symptom aggravation, cerebral hematoma enlargement, pulmonary embolism or other complications after treatment.ConclusionThese results indicated that the combination of sliding balloon-assisted thrombectomy, aspiration and intrasinus urokinase thrombolysis may be safe and effective for the treatment of CVST patients with intracranial hemorrhage.
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spelling doaj-art-7c940e0198fa47748b97fdc3d8b0c6bc2025-08-20T03:02:16ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.15193081519308Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patientsMingsi Zhang0Feixin Jiang1Qingyan Wen2Yiman Chen3Zhiquan Zhang4Min Zhang5Jianxin Zhong6Department of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaDepartment of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaDepartment of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaDepartment of Neurology, Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University, Shanwei, ChinaDepartment of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaDepartment of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaDepartment of Neurology, Jiangmen Central Hospital, Jiangmen, ChinaBackgroundCerebral venous sinus thrombosis (CVST) is an unusual cause of stroke. Currently, standard anticoagulant therapy does not have satisfactory efficacy for treating some cases of hemorrhagic CVST. Therefore, we explored the efficacy and safety of the combination of sliding balloon-assisted thrombectomy with aspiration and intrasinus urokinase thrombolysis for the treatment of CVST patients with intracranial hemorrhage (ICH).MethodsWe retrospectively analyzed the clinical, imaging and follow-up data of 10 CVST patients with ICH who underwent sliding balloon-assisted thrombectomy combined with aspiration and intrasinus thrombolysis with urokinase from February 2022 to June 2023. Complete recanalization and partial recanalization in the cerebral venous sinus were defined as imaging outcomes, and the modified Rankin score (mRS) at the 3-month and 6-month follow-ups was used to evaluate clinical efficacy.ResultsA total of 10 CVST patients aged 18–68 years were enrolled, including 5 males. All of the patients was diagnosed with ICH by noncontrast CT and with thrombosis at 3 or more venous sinuses by digital subtraction angiography (DSA). After treatment, complete recanalization was achieved in 6 patients, and partial recanalization was achieved in 4 patients. At the 3- and 6-month follow-up, all 10 patients showed neurological independence (mRS score ≤ 2), without any signs of symptom aggravation, cerebral hematoma enlargement, pulmonary embolism or other complications after treatment.ConclusionThese results indicated that the combination of sliding balloon-assisted thrombectomy, aspiration and intrasinus urokinase thrombolysis may be safe and effective for the treatment of CVST patients with intracranial hemorrhage.https://www.frontiersin.org/articles/10.3389/fneur.2025.1519308/fullcerebral venous sinus thrombosisintracranial hemorrhageballoon-assisted thrombectomyaspirationintrasinus thrombolysis
spellingShingle Mingsi Zhang
Feixin Jiang
Qingyan Wen
Yiman Chen
Zhiquan Zhang
Min Zhang
Jianxin Zhong
Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
Frontiers in Neurology
cerebral venous sinus thrombosis
intracranial hemorrhage
balloon-assisted thrombectomy
aspiration
intrasinus thrombolysis
title Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
title_full Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
title_fullStr Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
title_full_unstemmed Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
title_short Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients
title_sort sliding balloon assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis experience of 10 patients
topic cerebral venous sinus thrombosis
intracranial hemorrhage
balloon-assisted thrombectomy
aspiration
intrasinus thrombolysis
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1519308/full
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