Neuroradiology · 2026
Safety and efficacy of endovascular treatment in symptomatic pediatric cerebral venous sinus thrombosis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Li Jinyi, Wang Chunmei, Liu Kai, Fu Xiaojie, Liu Shuo, Xu Haowen, Gao Yuan, Guo Xinbin, Song Bo, Guan Sheng, Quan Tao
Аннотация
OBJECTIVE: Current guidelines recommend anticoagulation as the first-line treatment for pediatric cerebral venous sinus thrombosis (CVST), while the application, safety, and standardized regimen of endovascular treatment (EVT) in children remain controversial. This study aimed to evaluate the safety and efficacy of EVT for pediatric CVST and summarize the individualized endovascular strategy of thrombolysis and thrombectomy.
METHODS: A retrospective analysis was performed on pediatric patients (aged < 18 years) who received EVT for CVST at a single comprehensive medical center from March 2013 to November 2024. Baseline clinical data, imaging characteristics, procedural methods, perioperative complications, and follow-up outcomes were collected and analyzed.
RESULTS: A total of 45 pediatric CVST patients were enrolled, with a mean age of 14.8 years. The main clinical manifestations included headache (82.2%) and impaired consciousness (37.8%), and 88.9% of patients presented with multi-sinus thrombosis, accompanied by parenchymal hemorrhage in 31.1% of cases. The treatment strategies included simple thrombolysis (22.2%), simple thrombectomy (37.8%), and combined therapy (40.0%). The median daily individualized urokinase dose was 13,000 U/kg for 5-7 days. The median AVOIS score decreased from 5 at baseline to 2 at discharge. Two cases of intraoperative venous sinus perforation and one case of symptomatic intracranial hemorrhage were observed. At a median follow-up of 68 months, all patients achieved favorable functional outcomes.
CONCLUSION: Endovascular treatment represents a valuable rescue option for pediatric CVST patients with severe neurological symptoms. The dose of urokinase should be individualized during thrombolysis with or without mechanical thrombectomy.
METHODS: A retrospective analysis was performed on pediatric patients (aged < 18 years) who received EVT for CVST at a single comprehensive medical center from March 2013 to November 2024. Baseline clinical data, imaging characteristics, procedural methods, perioperative complications, and follow-up outcomes were collected and analyzed.
RESULTS: A total of 45 pediatric CVST patients were enrolled, with a mean age of 14.8 years. The main clinical manifestations included headache (82.2%) and impaired consciousness (37.8%), and 88.9% of patients presented with multi-sinus thrombosis, accompanied by parenchymal hemorrhage in 31.1% of cases. The treatment strategies included simple thrombolysis (22.2%), simple thrombectomy (37.8%), and combined therapy (40.0%). The median daily individualized urokinase dose was 13,000 U/kg for 5-7 days. The median AVOIS score decreased from 5 at baseline to 2 at discharge. Two cases of intraoperative venous sinus perforation and one case of symptomatic intracranial hemorrhage were observed. At a median follow-up of 68 months, all patients achieved favorable functional outcomes.
CONCLUSION: Endovascular treatment represents a valuable rescue option for pediatric CVST patients with severe neurological symptoms. The dose of urokinase should be individualized during thrombolysis with or without mechanical thrombectomy.