Direct thrombectomy using the Penumbra thromboaspiration catheter for the treatment of cerebral venous sinus thrombosis

Objective: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke. A 21 year-old female presented to our institution in a rapidly deteriorating neurological state following failed systemic heparin therapy for treatment of superior sagittal sinus (SSS) thrombosis. Methods: The patient underwent emergent mechanical thrombectomy of the thrombosed SSS using the 0.054-inch Penumbra catheter. No adjuvant direct pharmacologic and/or mechanical thrombectomy was performed. Results: Successful venous recanalization was achieved using the Penumbra system. The patient improved symptomatically following the intervention, and she made a complete neurological recovery within 30 days. At 6-month follow-up, the patient had returned to work and school and remained neurologically intact. A repeat MRV showed complete sinus recanalization. Conclusion: Direct mechanical thrombectomy using the Penumbra system provided rapid sinus recanalization for the treatment of symptomatic cerebral venous sinus thrombosis. This device is a valuable addition to the neurointerventional armamentarium.