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Can mechanical thrombectomy be effective in deep cerebral venous thrombosis worsening on anticoagulant? Insight from two cases

2023; Elsevier BV; Volume: 32; Issue: 12 Linguagem: Inglês

10.1016/j.jstrokecerebrovasdis.2023.107398

1532-8511

Marine Glineur, Anne Dusart, Nicolas Cavez, Illario Tancredi, Flavio Bellante,

Acute Ischemic Stroke Management

Objective Cerebral venous thrombosis (CVT) is a rare condition whose clinical presentation can range from simple headaches to severe impairment of alertness. Some clinical forms, such as involvement of the deep venous system, are associated with a poorer clinical prognosis despite well-managed anticoagulation. The role and timing of rescue mechanical thrombectomy for these patients is not well established. Method Clinical and imaging follow-up are discussed according to our treatment decision. Results We describe two cases with deep venous system thrombosis that were treated unsuccessfully with optimal anticoagulation, with a spectacular clinical and radiological response after mechanical thrombectomy (MT). Conclusion These cases demonstrate that, despite the negative results of the TO-ACT trial, MT could be considered as a rescue treatment in some clinical forms of deteriorating CVT despite optimal anticoagulation.