Use of the Penumbra Indigo Aspiration System in the treatment of Cerebral Venous Sinus Thrombosis

Background: In this abstract, the use of the Penumbra Indigo Aspiration System for the treatment of CVST in a timely manner is discussed in a 35-year-old male patient who presented with altered mental status with optimal outcomes on follow-up angiogram performed weeks later after recovery in the neuro-ICU.

Case: Angiogram revealed slow perfusion with inadequate drainage in the dural sinuses. The distal portion of the SSS and bilateral transverse sinuses were completely occluded. Complete occlusion of the transverse sinuses was also seen on angiogram of the right IJ vein. An Aristotle 24, 200-cm guidewire was inserted into a 160-cm-long Zoom 35 catheter, and this system was advanced within the CAT12 aspiration catheter using a right IJ 12 French Sheath under fluoroscopy across occlusions in the SSS and bilateral transverse sinuses. To access thrombi located proximally in the SSS, the CAT8 and then CAT7 were advanced with aid of a separator device. Evidence of partial recanalization of the SSS and improved venous flow of the bilateral sigmoid sinuses and bilateral transverse sinuses was visualized.

Discussion: This is the first reported use of the Penumbra Indigo Aspiration System in the treatment of CVST to our knowledge. The Penumbra Indigo Aspiration System could serve as a useful tool in the angiography suite and should be further explored.

Publication History

Article published online:
09 February 2023