P026/285 Endovascular thrombectomy for cerebral venous sinus thrombosis using the penumbra indigo aspiration system

Introduction

We use the Penumbra Indigo® Aspiration System for the treatment of CVST in a timely manner for a 35-year-old male patient who presented with altered mental status with optimal outcomes on follow-up angiogram.

Aim of Study

We report our initial experience in the treatment of CVST using the Penumbra Indigo® Aspiration System.

Methods

Angiogram revealed slow perfusion with inadequate drainage in the dural sinuses. The distal portion of the SSS and bilateral transverse sinuses were completely occluded. Complete occlusion of the transverse sinuses was also seen on angiogram of the right IJ vein. An Aristotle 24, 200-cm guidewire was inserted into a 160-cm-long Zoom 35 catheter, and this system was advanced within the CAT12 aspiration catheter using a right IJ 12 French Sheath under fluoroscopy across occlusions in the SSS and bilateral transverse sinuses. To access thrombi located proximally in the SSS, the CAT8 and then CAT7 were advanced with aid of a separator device. Evidence of partial recanalization of the SSS and improved venous flow of the bilateral sigmoid sinuses and bilateral transverse sinuses was visualized.

Results

Evidence of partial recanalization of the SSS and improved venous flow of the bilateral sigmoid sinuses and bilateral transverse sinuses was visualized on initial and follow-up.

Conclusion

The Penumbra Indigo® Aspiration System has been used in various arterial and venous systems but this is the first report to demonstrate its technical feasibility in thrombectomy for CVST. Further feasibility studies are necessary to inform its applicability in CVST.

Disclosure of Interest

This case has been published, however, we would like to share the case if allowed.