Abstract

Background: Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening condition that can lead to significant neurological deficits. While medical management with anticoagulation is the standard treatment, some cases of CVT are resistant to medical therapy. In such situations, mechanical thrombectomy (MT) has emerged as a potential alternative. We present a case series highlighting the role of MT in patients with medically refractory CVT. Methods: This is a retrospective case series of patients diagnosed with CVT who underwent mechanical thrombectomy due to failure of medical management. Clinical, imaging, and procedural data were reviewed to assess the safety and effectiveness of the intervention. Results: A total of six patients, ranging from 29 to 81 years old, were included. All patients had failed conventional anticoagulation therapy and presented with worsening symptoms, including increased intracranial pressure, progressive neurological deficits, and impaired consciousness. Mechanical thrombectomy was successfully performed in all patients. Post-procedural outcomes showed significant improvements in neurological status, with four out of six patients achieving a modified Rankin Scale (mRS) score of 0 at three months. Two patients had a mRS score of 3, but their symptoms were markedly improved. Conclusion: Mechanical thrombectomy can be an effective treatment for patients with medically refractory CVT. Early identification of patients at risk of poor outcomes despite medical therapy and timely intervention with thrombectomy may significantly improve functional outcomes.

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