Related Experiment Video

Updated: Sep 2, 2025

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

17.4K

Direct Oral Anticoagulants Versus Vitamin K Antagonists in Cerebral Venous Thrombosis: A Systematic Review and

Shadi Yaghi1, Ian J Saldanha2, Chelsea Misquith3

  • 1Department of Neurology, Brown University, Providence, RI (S.Y., B.Z., A.S., K.J., B.P., L.S., E.D.G., K.F.).

Stroke
|August 8, 2022
PubMed
Abstract

Insights

Direct oral anticoagulants (DOACs) show comparable efficacy and safety to warfarin for cerebral venous thrombosis patients. Further research is needed to confirm these findings in anticoagulant therapy.

Area of Science:

  • Neurology
  • Hematology
  • Pharmacology

Background:

  • High-level evidence for direct oral anticoagulants (DOACs) in cerebral venous thrombosis (CVT) is limited.
  • Vitamin K antagonists (VKAs) are a standard treatment, but DOACs offer potential advantages.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of DOACs compared to VKAs in patients with CVT.
  • To assess outcomes including recurrent venous thromboembolism, complete recanalization, and major hemorrhage.

Main Methods:

  • Systematic review and meta-analysis of randomized and non-randomized studies.
  • Searched multiple databases (MEDLINE, EMBASE, CINAHL, Web of Science) for studies comparing DOACs and VKAs in CVT patients.
  • Included 19 studies (3 RCTs, 16 observational studies) with 1950 patients.

Main Results:

  • DOACs demonstrated comparable efficacy to VKAs regarding recurrent venous thromboembolism (RR 0.85) and complete venous recanalization (RR 0.98).
  • Safety outcomes, including major hemorrhage (RR 0.70) and intracranial hemorrhage (RR 0.58), were also comparable between DOACs and VKAs.
  • No significant differences were observed in mortality rates between the two anticoagulant groups.

Conclusions:

  • Direct oral anticoagulants (DOACs) and warfarin appear to have comparable efficacy and safety profiles for treating cerebral venous thrombosis.
  • Findings should be interpreted cautiously due to limitations, including a low number of RCTs and modest sample sizes.
  • Further confirmation from ongoing randomized controlled trials and large prospective studies is warranted.
Keywords:
anticoagulationcerebral venous thrombosisdirect oral anticoagulantsvitamin K antagonistswarfarin

More Related Videos

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment08:36

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment

Published on: April 19, 2024

687
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

9.8K

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
18
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
867
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
30
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
37
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
21