Cohort analysis of carotid artery puncture injection of urokinase combined with warfarin for the treatment of cerebral venous sinus thrombosis.

Purpose: Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease with increased intracranial pressure from impaired cerebral venous drainage and absorption of cerebrospinal fluid. There is a lack of evidence to prove the benefits and risks of thrombolytic and anticoagulant therapies. We conducted a retrospective analysis of the therapeutic effect of carotid artery puncture injections of urokinase combined with warfarin in patients with CVST.

Methods: Thirty-six patients with CVST who received a carotid artery puncture injection of urokinase combined with warfarin were retrospectively analyzed in the urokinase group, while 30 patients with CVST received subcutaneous low-molecular-weight heparin (LMWH) and warfarin, as the control group. Clinical parameters, imaging data, laboratory test data, treatment plans, and follow-up information were collected and compared.

Results: At discharge, the GCS score was higher in the urokinase group than that in the control group. In the urokinase group, no patient died. Recanalization of the venous sinus trunk was observed in 32 patients. While two patients died in the control group, recanalization of the venous sinus trunk was achieved in 20 patients. A follow-up examination showed that recovery in the urokinase group was also better than that in the control group.

Conclusion: This study suggests that carotid artery puncture injection of urokinase combined with warfarin is a safe and effective option for CVST, can reduce CVST recurrence. However, this was a retrospective study with a relatively small sample size, and future studies are needed to confirm the procedure's feasibility.