Dural Venous Sinus Intervention
Dural Venous Sinus Intervention
Most patients with dural venous sinus thrombosis (DVST), which is blood clots of major brain veins, recover after receiving anticoagulants. But for a small group of high-risk patients, an intervention with minimally invasive treatment can boost outcomes. At Vascular & Interventional Partners in Scottsdale, AZ, we have extensive experience treating patients at risk of complications of DVST.
What Is Dural Venous Sinus Intervention?
DVST intervention refers to interventional radiology techniques used to treat DVST. Also known as cerebral venous sinus thrombosis, DVST refers to rare blood clots in the veins of the dural sinuses that can lead to stroke if left untreated.
For the great majority of patients, blood thinners (heparin or coumadin) help dissolve the blood clot and restore normal blood flow. However, in patients with serious DVST symptoms, an additional interventional radiology treatment can boost the chances of recovery. Two techniques we use to treat DVST are:
- Thrombectomy — This emergency treatment uses X-ray image guidance and flexible catheters to guide a stent retriever toward the blood clot. A stent retriever is a mesh tube that traps blood clots for easy removal.
- Thrombolysis — Like thrombectomy, this treatment involves X-ray guidance and catheters to deliver medication sometimes directly to the clogged vein. Usually, doctors choose thrombolytic or “clot-busting” medication for this treatment, but occasionally they may use tiny devices to mechanically dislodge the clot.
Benefits of Dural Venous Sinus Intervention
Most patients with DVST can be safely treated with anticoagulants. These drugs dissolve the blood clot blocking major veins in the brain over the course of several hours. In patients who do not respond to these drugs as expected or who have severe symptoms, doctors may choose DVST interventions since they provide the following benefits:
- Greater efficiency — Some blood clots do not dissolve fast enough with anticoagulant injections. Directly administering thrombolytic drugs to the blood clot leads to more efficient results.
- Immediate effects — If patients require quick treatment, the use of mechanical thrombolysis can restore blood flow in the brain within minutes.
- Effective against large clots — Anti-coagulants alone or even thrombolytic drugs are not enough to dissolve particularly large clots. In that case, interventional radiologists can combine thrombectomy with thrombolysis to remove the clot.
- Better outcomes — Patients who do not recover fast enough or who have severe clots benefit greatly by having an additional treatment option aside from anticoagulants.
Why Choose Vascular & Interventional Partners?
At Vascular & Interventional Partners in Scottsdale, AZ, our interventional radiologists are the most respected division in the state, known for doing high-level cases and getting patient transfers from outside hospitals. Our doctors are experienced in performing acute procedures on some of the most critically ill patients using cutting-edge and complex techniques.
As leaders in minimally invasive procedures, our doctors have gained the trust of a wide network of referring physicians. To maintain the highest quality standards, our interventional radiologists are also members of the Society of Interventional Radiology (SIR), Outpatient Endovascular and Interventional Society (OEIS), and other professional organizations. Our team includes physician assistants, nurses, and technicians to streamline patient care, especially for high-risk groups.
By choosing Vascular & Interventional Partners, patients and physicians can rest assured they are in good hands. Because our patients are at the center of everything we do, we strive to use our deep knowledge of minimally invasive procedures to improve patient outcomes.
Frequently Asked Questions
What are dural venous sinuses?
Dural venous sinuses are seven major blood channels that drain deoxygenated blood from the brain back to the lungs and heart. Some of these sinuses also have additional roles in circulating cerebrospinal fluid.
Who is at risk of dural sinus thrombosis?
Dural sinus thrombosis is extremely rare, affecting five out of a million people each year. Groups most at risk of developing this condition are pregnant and postpartum women, people with conditions that affect blood clots, cancer patients, and those with certain inflammatory conditions.
What are the symptoms of dural sinus thrombosis?
Symptoms of dural sinus thrombosis vary depending on the location of the blood clot. Usual symptoms include headache, blurred vision, fainting or loss of consciousness, inability to move a limb, and difficulty speaking. In women who are about to or have given birth, seizures are also common.
What should I do if I have symptoms of dural sinus thrombosis?
Respond quickly by having someone take you to an emergency room or call 911. Dural sinus thrombosis is a medical emergency that requires an immediate response to avoid serious complications, including death.
When should you receive thrombectomy/thrombolysis?
Most patients need to have a thrombectomy or thrombolysis within eight hours after their symptoms begin for these treatments to be effective. However, doctors may choose to perform these procedures even twelve hours after the symptoms begin.
How safe is a mechanical thrombectomy?
The safety of mechanical thrombectomy was extensively studied in stroke patients. So far, research has shown it to be a safe and effective procedure. Less is known about its safety in dural venous sinus thrombosis because this condition is extremely rare and hard to study. However, we have seen first-hand that this procedure can be effective in some cases.