Introduction The standard acute treatment of Cerebral Venous Thrombosis (CVT) is anticoagulation. After several uncontrolled studies and one randomized clinical trial, there is still uncertainty regarding the role of endovascular treatment (EVT) in this scenario.
Aim of Study To evaluate safety and efficacy of EVT in CVT combined with best medical care.
Methods We performed a retrospective analysis of an international two-center registry.
Results EVT was performed in 20% (12/58) of CVT patients with a median time from diagnosis to treatment of 4.5h (1.25–28.5). Compared to medical therapy alone, EVT patients had higher baseline NIHSS [median 5.5 (2–17) vs 0 (0–3) p=0.004] and basal CT showed higher rates of intracerebral hemorrhage (41.7% vs 6.4%, p=0.006). EVT was performed using transjugular access in half of the patients and transfemoral access in the other half. Aspiration with large bore catheters was performed in every case with angioplasty in 7 out of 12 patients and stenting in 3 out of 12 patients. Recanalization was achieved in 75% of the patients with a median time from puncture to recanalization of 90 (74.3–157.5) minutes. No postprocedural complications were observed. We found a significant improvement from baseline to discharge median NIHSS in patients submitted to EVT [5.5 (2–17) vs 1(0–3.75) p<0.001].
Conclusion In our series, endovascular treatments in CVT combined with anticoagulation was safe and efficacious as evidenced by angiographic findings and clinical improvement.
Disclosure of Interest Nothing to disclose
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