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Risk of Pulmonary Embolism After Cerebral Venous Thrombosis

Ava L Liberman1, Alexander E Merkler2, Gino Gialdini1

  • 1From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).

Stroke
|February 24, 2017
PubMed

Insights

The risk of pulmonary embolism (PE) after cerebral vein thrombosis (CVT) is significantly lower than after deep venous thrombosis (DVT). For CVT patients, the highest PE risk occurs during initial hospitalization.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Cerebral vein thrombosis (CVT) is a form of venous thromboembolism.
  • The comparative risk of pulmonary embolism (PE) following CVT versus deep venous thrombosis (DVT) remains unclear.

Purpose of the Study:

  • To investigate and compare the risk of PE in patients diagnosed with CVT versus DVT.
  • To determine if CVT poses a similar or different risk for subsequent PE compared to DVT.

Main Methods:

  • Retrospective cohort study utilizing administrative data from California, New York, and Florida (2005-2013).
  • Identification of patients with CVT or DVT and subsequent PE using validated ICD-9-CM codes.
  • Kaplan-Meier survival analysis and Cox proportional hazards models were employed for risk comparison.

Main Results:

  • A cohort of 4,754 CVT patients and 241,276 DVT patients was analyzed.
  • The cumulative incidence of PE at 5 years was 3.4% for CVT versus 10.9% for DVT (P<0.001).
  • CVT was associated with a substantially lower adjusted hazard of PE (HR, 0.26; 95% CI, 0.22-0.31) compared to DVT.

Conclusions:

  • The risk of developing PE after CVT is significantly lower than after DVT.
  • The highest risk period for PE in CVT patients is during the initial hospitalization.
Abstract

Keywords:
cerebral venous thrombosisdeep vein thrombosispulmonary embolismthrombosisvenous thromboembolism

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