C14 Treatment of a massive cerebral venous sinus thrombosis with lightning 12 device

<h3>Introduction</h3> Endovascular techniques, unlike in the case of ischemic stroke, have not yet found strong indications for the treatment of CVST. This is also due to the fact that the available instruments are optimized for the calibers of intracranial arteries, making them too small and less effective for the removal of large thrombotic burdens in the major dural sinuses. <h3>Case Description</h3> We present the case of a 51-year-old male patient presenting with a headache ongoing for approximately one week, seeking emergency care for clinical deterioration with the onset of mental confusion, difficulty coordinating limbs, and dysarthria. Initial imaging reveals extensive thrombosis of the superior sagittal sinus, right transverse and sigmoid sinuses, and the proximal portion of the left transverse sinus, along with a small left parietal hemorrhagic focus. Despite the initiation of anticoagulant therapy (enoxaparin 8000 IU twice daily), 24 hours later the patient experienced clinical deterioration with an increase in intraparenchymal hemorrhage, leading to evacuation surgery. Endovascular treatment was then indicated. A 12F, 80 cm long introducer is advanced via the right common femoral vein to the right jugular bulb, through which thromboaspiration is performed using a Lightning 12 catheter up to superior sagittal sinus, allowing the removal of most of the thrombotic burden. <h3>Conclusions</h3> Real large-bore aspiration catheters are currently being developed for the treatment of pulmonary thromboembolism and extensive iliac-femoral deep vein thrombosis. The use of these devices for the treatment of CVST could achieve excellent angiographic and clinical outcomes while significantly reducing procedural times. <h3>Conflict of Interest</h3> No