Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review

Background: Endovascular treatment of cerebral venous sinus thrombosis (CVST) includes pharmacological and mechanical thrombolysis.

Methods: The authors searched the English literature on CVST from 1990 to 2012 for all case reports or case series of mechanical thrombectomy.

Results: A total of 64 patients were treated in all published studies. The techniques for mechanical thrombectomy included rheolytic thrombectomy with an AngioJet device (46.9%), clot retraction with the Penumbra system (4.7%), clot retraction with a Fogarty catheter (1.6%), clot retraction with a microsnare (3.1%), balloon venoplasty without stenting (18.7%), balloon venoplasty with stenting (4.7%), and an amalgam of techniques (18.7%). Nine (16.1%) patients died. At the most recent follow-up, 40 (62.5%) patients had no disability or minor disability and 7 (10.9%) patients had major disability.

Conclusion: Randomized multiinstitutional clinical trials with larger number of participants are needed to sufficiently compare the effect of intrasinus thrombolysis and mechanical thrombectomy to standard-of-care anticoagulation therapy.