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Case Reports
. 2010 Dec;16(4):455-8.
doi: 10.1177/159101991001600414. Epub 2010 Dec 17.

Successful intravascular ultrasound thrombolysis of dural sinus thrombosis with pre-existing subarachnoid and intraparenchymal hemorrhages

M E Atherton  1 , W C Culp, A T Brown, E Erdem
Affiliations
Case Reports

Successful intravascular ultrasound thrombolysis of dural sinus thrombosis with pre-existing subarachnoid and intraparenchymal hemorrhages

M E Atherton et al. Interv Neuroradiol. 2010 Dec.

Abstract

A case of cerebral venous thrombosis with intraparenchymal and subarachnoid hemorrhages was initially treated unsuccessfully with mechanical and pharmacologic thrombolysis using intrathrombus tissue plasminogen activator (tPA) and angioplasty, and later successfully treated with an intravascular ultrasound tPA infusion catheter. This new microcatheter allowed direct infusion of tPA while using local therapeutic intravascular ultrasound to increase the thrombolytic effect. Flow was quickly restored. Our patient recovered from coma to discharge home without worsening of existing hemorrhages.

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Figures

Figure 1
Figure 1
Preliminary CT. Non-contrast head CT prior to catheter directed treatment showing right basal ganglia hemorrhage, subarachnoid hemorrhage, and venous sinus thrombosis.
Figure 2
Figure 2
Cerebral venogram. Lateral view with injection through a micro catheter showing near complete occlusion of the superior sagittal sinus and diverted venous flow anteriorly through the inferior sagittal sinus, prior to ultrasound therapy..
Figure 3
Figure 3
Cerebral angiogram. Venous phase of cerebral angiogram showing improved flow through dural venous sinuses following ultrasound thrombolysis.
See this image and copyright information in PMC

References

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