CDT & THROMBUS ASPIRATION FOR CEREBRAL VENOUS SINUS THROMBOSIS

Cerebral venous sinus thrombosis (CVST) is a blockage of the dural sinuses, the channels that drain blood from the brain. Standard treatment involves anticoagulation medications to prevent further clotting and improve blood flow. However, some patients don’t respond well to medication and require a more aggressive approach. This is where CDT (Catheter Directed Thrombolysis) and thrombus aspiration with interventional radiology (IR) come into play.

Catheter Directed Thrombolysis (CDT):

• CDT involves delivering clot-busting medication (thrombolytic agents) directly to the thrombus through a catheter inserted into a vein.
• This targeted approach minimizes the risk of bleeding complications associated with systemic administration of thrombolytics.
• During the procedure, an IR specialist guides the catheter using fluoroscopy (real-time X-ray imaging) to the site of the blockage.
• The thrombolytic agent is then delivered through the catheter to dissolve the clot.

Thrombus Aspiration:

• Thrombus aspiration involves mechanically removing the clot using a specialized catheter.
• The IR specialist advances the catheter into the blocked sinus and creates suction to remove the clot material.
• This technique can be particularly useful for large or dense clots that may not respond well to CDT alone.

Combined Approach:

• Often, CDT and thrombus aspiration are used together for a more comprehensive treatment approach.
• CDT can help break up the clot, making it easier for the aspiration catheter to remove the fragments.

Benefits of IR Treatment for CVST:

• Minimally invasive compared to open surgery.
• Targeted approach reduces bleeding risk.
• Potentially faster improvement in symptoms.
• May improve long-term outcomes.

Important Considerations:

• These procedures are complex and require expertise in IR techniques.
• They are not suitable for all patients with CVST.
• There is a risk of bleeding, infection, and vessel injury during the procedure.

Overall, CDT and thrombus aspiration with IR offer a valuable treatment option for patients with CVST who are not responding well to traditional medical management. These minimally invasive procedures can help improve blood flow, reduce symptoms, and potentially improve long-term outcomes.

Additional Notes:

• IR specialists are physicians with additional training in image-guided minimally invasive procedures.
• The decision for CDT, thrombus aspiration, or a combination of both will be made by a team of specialists based on the individual patient’s condition.
• For further details on the specific techniques and risks involved, consulting with a qualified neurointerventional radiologist is recommended.