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

• Published in: Interventional neuroradiology 2024-03, p.15910199241236819
• Main Authors: Sousa, João André, Achutegui, Maider Iza, Juega-Mariño, Jesus, Requena, Manuel, Bernardo-Castro, Sara, Rodrigo-Gisbert, Marc, Rizzo, Federica, Olivé, Marta, Garcia-Tornel, Álvaro, Chaves, Ana Carolina, Rodriguez-Villatoro, Noelia, Muchada, Marian, Pagola, Jorge, Rodriguez-Luna, David, Rubiera, Marta, Martins, Ana Inês, Silva, Fernando, Veiga, Ricardo, Nunes, Cesar, Machado, Egídio, Diana, Francesco, de Dios, Marta, Hernández, David, Ribo, Marc, Molina, Carlos, Sargento-Freitas, João, Tomasello, Alejandro
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 1591-0199; 2385-2011; 2385-2011
• DOI: 10.1177/15910199241236819

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. 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. 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),  = 0.002)] and a higher incidence of intracerebral hemorrhage (53.8% vs 20.3%,  = 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);