Acute management of cerebral venous thrombosis: Indications, technique, and outcome of endovascular treatment in two high-volume centers

João André Sousa, Maider Iza Achutegui, Jesus Juega-Mariño, Manuel Requena, Sara Bernardo-Castro, Marc Rodrigo-Gisbert, Federica Rizzo, Marta Olivé, Álvaro Garcia-Tornel, Ana Carolina Chaves, Noelia Rodriguez-Villatoro, Marian Muchada, Jorge Pagola, David Rodriguez-Luna, Marta Rubiera, Ana Inês Martins, Fernando Silva, Ricardo Veiga, Cesar Nunes, Egídio MachadoFrancesco Diana, Marta de Dios, David Hernández, Marc Ribo, Carlos Molina, João Sargento-Freitas, Alejandro Tomasello

Producción científica: Artículo en revista indizadaArtículorevisión exhaustiva


Introduction: After several uncontrolled studies and one randomized clinical trial, there is still uncertainty regarding the role of endovascular treatment (EVT) in cerebral venous thrombosis (CVT). This study aims to describe and assess different acute management strategies in the treatment of CVT. Methods: We performed a retrospective analysis of an international two-center registry of CVT patients admitted since 2019. Good outcome was defined as a return to baseline modified Rankin scale at three months. We described and compared EVT versus no-EVT patients. Results: We included 61 patients. Only one did not receive systemic anticoagulation. EVT was performed in 13/61 (20%) of the cases, with a median time from diagnosis to puncture of 4.5 h (1.25–28.5). EVT patients had a higher median baseline NIHSS [6 (IQR 2–17) vs 0 (0–2.7), p = 0.002)] and a higher incidence of intracerebral hemorrhage (53.8% vs 20.3%, p = 0.03). Recanalization was achieved in 10/13 (77%) patients. Thrombectomy was performed in every case with angioplasty in 7 out of 12 patients and stenting in 3 cases. No postprocedural complication was reported. An improvement of the median NIHSS from baseline to discharge [6 (2–17) vs 1(0–3.75); p < 0.001] was observed in EVT group. A total of 31/60 patients (50.8%) had good outcomes. Adjusting to NIHSS and ICH, EVT had a non-significant increase in the odds of a good outcome [aOR 1.42 (95%CI 0.73–2.8, p = 0.307)]. Conclusions: EVT in combination with anticoagulation was safe in acute treatment of CVT as suggested by NIHSS improvement. Selected patients may benefit from this treatment.

Idioma originalInglés
PublicaciónInterventional Neuroradiology
EstadoAceptada/en prensa - 2024
Publicado de forma externa


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