Endovascular recanalization with balloon angioplasty and stenting of an occluded occipital sinus for treatment of XXXX : technical case report.

@entity1 @entity932 @entity2657 @entity101 @entity1276 @entity428 @entity1269 @entity2026 @entity715 @entity50
OBJECTIVE AND IMPORTANCE: @entity50 can lead to @entity428 and can be complicated by @entity932 . We present a case report of a @entity1 who underwent endovascular recanalization and stenting of a thrombosed occipital sinus. CLINICAL PRESENTATION: A 13-year-old @entity1 with a history of chronic @entity50 refractory to anticoagulant therapy presented with acute onset of @entity2026 and @entity1269 . Computed tomography and magnetic resonance imaging revealed @entity1276 and @entity2657 . Angiography delineated multiple dural arteriovenous fistulae and persistent occlusion of the posterior sagittal, occipital, and bilateral transverse dural sinuses with retrograde cortical venous drainage. INTERVENTION: After embolization of the dural arteriovenous fistulae, a transvenous approach was used to recanalize and perform balloon angioplasty of the right internal jugular vein and the occipital and left transverse sinuses, resulting in subsequent clinical improvement. The @entity1 's condition deteriorated 3 days later with reocclusion of both balloon-dilated sinuses. Repeat angioplasty and then deployment of an endovascular stent in the occipital sinus were performed, and reestablishment of venous outflow was achieved, resulting in a decrease of intracranial venous pressure from 41 to 14 mm Hg and neurological improvement. At the 3-month follow-up examination, the stented occipital sinus remained patent and served as the only conduit for extracranial venous outflow; the @entity1 remained neurologically intact at the 12-month follow-up examination. CONCLUSION: This is the first report of mechanical recanalization, balloon angioplasty, and stent deployment in the occipital sinus to provide sustained venous outflow for the treatment of @entity101 with retrograde cortical venous drainage in a @entity1 with dural pansinus @entity715 refractory to anticoagulant therapy.
