Transfemoral thrombectomy in the cavernous sinus and superior ophthalmic vein

Cavernous sinus thrombosis (CST) is a rare condition that can cause death, neurologic disability, and visual loss. A pre-teen with septic CST leading to ocular hypertension and acute visual loss was treated at our institution with thrombectomy and thrombolysis of the cavernous sinuses and superior o...

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Bibliographic Details
Published in:BMJ case reports 2018-02, Vol.2018, p.bcr-2017-013571
Main Authors: Bauer, Justin, Kansagra, Kartik, Chao, Kuo H, Feng, Lei
Format: Article
Language:English
Subjects:
Angioplasty
Anticoagulants - administration & dosage
Blood clots
Case reports
Catheters
Cavernous Sinus Thrombosis - complications
Cavernous Sinus Thrombosis - diagnostic imaging
Cavernous Sinus Thrombosis - therapy
Child
Endoscopy
Fluoroscopy
Humans
Infections
Male
Neuroimaging
Nose
Ocular Hypertension - etiology
Orbit - blood supply
Orbit - diagnostic imaging
Patients
Plasminogen Activators - administration & dosage
Retreatment - methods
Sinuses
Stroke
Surgery
Thrombectomy - methods
Thrombosis
Tomography, X-Ray Computed
Veins & arteries
Veins - diagnostic imaging
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - therapy
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Summary:Cavernous sinus thrombosis (CST) is a rare condition that can cause death, neurologic disability, and visual loss. A pre-teen with septic CST leading to ocular hypertension and acute visual loss was treated at our institution with thrombectomy and thrombolysis of the cavernous sinuses and superior ophthalmic veins. Successful recanalization of the bilateral cavernous sinuses and superior ophthalmic veins was achieved in two separate procedures without complication. The patient showed immediate symptomatic relief. He was neurologically intact without visual deficits at the 2 month follow-up. This is the first report in the literature showing the feasibility of cavernous sinus thrombectomy using current devices and techniques. Early endovascular therapy may help preserve vision in patients with acute CST.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-013571