Objective To evaluate the efficacy, safety and prognosis of intravascular multi-mode combined therapy based on balloon-assisted thrombolysis and intermediate catheter aspiration for severe cerebral venous sinus thrombosis. Methods Clinical data of 13 patients with severe cerebral venous sinus thrombosis treated with intravascular multi-mode combined therapy based on balloon-assisted thrombolysis and intermediate catheter aspiration were retrospectively analyzed. Glasgow coma score （GCS） and Barthel index score before and 1 week after operation were recorded. Clinical prognosis was evaluated by modified Rankin scale （mRS） and recanalization of occlusion was evaluated by brain magnetic resonance venography （MRV） or digital subtraction angiography （DSA）. Results In case 1, the occlusion of the superior sagittal sinus and double frontal top branch veins was partially recanalized. In case 9, the occlusion of the right transverse sinus and sigmoid sinus was partially recanalized. In case 7 and case 13, chronic occlusion of the left transverse sinus and left sigmoid sinus was not recanalized, whereas the other venous sinuses were completely recanalized. The remaining 9 patients achieved complete recanalization. The GCS and Barthel index score at postoperative 1 week were significantly higher than those before operation （both P < 0.05）. No intervention-induced complications occurred intraoperatively or postoperatively. During postoperative 6-month follow-up, favorable outcomes （mRS≤2） were achieved in 10 patients and complete recanalization was obtained in 9 patients. Conclusion Intravascular multi-mode combined treatment based upon balloon thrombolysis and intermediate catheter aspiration is efficacious and safe for severe intracranial venous sinus thrombosis, which yields high clinical prognosis.
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