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Effect of recanalization on clinical outcomes in patients with cerebral venous thrombosis - An ambispective study

Naga Karthik Vanukuri1, Radhakrishna Pedapati1, Sundar Shanmugam1

  • 1Department of Neurology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, Tamil Nadu, India.

European Journal of Radiology
|June 6, 2022
PubMed

Insights

Recanalization significantly improves outcomes in cerebral venous sinus thrombosis (CVST). Factors like sinus involvement and decompressive craniectomy impact prognosis, highlighting recanalization

Area of Science:

  • Neurology
  • Vascular Medicine
  • Radiology

Background:

  • Cerebral venous sinus thrombosis (CVST) is a rare but serious condition.
  • The benefits of achieving complete recanalization in CVST are not fully established.
  • Understanding factors influencing recanalization and patient outcomes is crucial for effective management.

Purpose of the Study:

  • To assess the factors associated with recanalization in patients with CVST.
  • To evaluate the effect of recanalization on patient outcomes.
  • To determine the prognostic significance of recanalization status in CVST.

Main Methods:

  • A single-center, ambispective observational study included 123 patients diagnosed with CVST.
  • Data collected included demographic, clinical, and radiological features, modified Rankin Scale (mRS) scores, and recanalization status.
  • Patients were followed for one year or until complete recanalization, with periodic check-ups every three months.

Main Results:

  • Thrombophilia and hematological conditions were the predominant risk factors for CVST.
  • Most patients (95.5%) achieved a favorable modified Rankin Scale (mRS) score of 0-1 at three months.
  • Complete recanalization was achieved in 67.5% of patients, and partial recanalization in 21.7%.
  • Failure to achieve at least partial recanalization and undergoing decompression craniectomy were independent predictors of poor functional outcomes.
  • Transverse and sigmoid sinus involvement independently predicted poor recanalization.

Conclusions:

  • The majority of patients with CVST experience favorable outcomes.
  • Recanalization is a strong predictor of good functional outcomes in CVST patients.
  • Recanalization status should guide decisions regarding the cessation of anticoagulation therapy.
  • No significant difference in outcomes was observed between partial and complete recanalization groups.
Abstract

Keywords:
Cerebral venous/sinus thrombosisModified Rankin scaleRecanalization

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