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Endovascular treatment for cerebral venous thrombosis: a multicenter study in China

He-Tao Bian1, Xia Wang2, Gui-You Liu1

  • 1Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China.

Military Medical Research
|April 8, 2025
PubMed

Insights

Endovascular treatment (EVT) did not improve functional outcomes for cerebral venous thrombosis (CVT) patients compared to standard care. This large study found no significant difference in recovery or death rates between treatments.

Area of Science:

  • Neurology
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Cerebral venous thrombosis (CVT) management is evolving, with increasing interest in endovascular treatment (EVT).
  • Limited evidence currently exists regarding the efficacy and safety of EVT for severe CVT cases.
  • This study addresses the need for robust data on EVT's role in CVT treatment.

Purpose of the Study:

  • To evaluate the association between endovascular treatment (EVT) and functional outcomes in patients with severe cerebral venous thrombosis (CVT).
  • To compare the effectiveness of EVT versus standard care in improving functional recovery and reducing mortality in CVT patients.

Main Methods:

  • A multicenter study involving 2774 adult patients with CVT across 104 hospitals in China (January 2018 - June 2022).
  • Propensity score weighting was utilized to adjust for baseline confounding variables.
  • The primary outcome was good functional status (modified Rankin Scale score 0-1) post-discharge.

Main Results:

  • No significant difference in good functional recovery was observed between the EVT group (449 patients) and the standard care group (2325 patients) (wRR 1.00, 95% CI 0.96-1.03).
  • Mortality rates at hospital discharge also showed no significant difference between the groups (wRR 1.91, 95% CI 0.91-3.68).
  • Subgroup analyses indicated a potentially lower likelihood of good functional recovery in patients with intracerebral hemorrhage (wRR 0.88, 95% CI 0.79-0.98) and seizures (wRR 0.86, 95% CI 0.76-0.95) who received EVT.

Conclusions:

  • Endovascular treatment (EVT) was not associated with improved functional outcomes compared to standard care for patients with cerebral venous thrombosis (CVT).
  • The findings suggest that EVT may not be superior to standard care for the general CVT population.
  • Further research is needed to identify specific subgroups of CVT patients who might benefit from EVT.
Abstract

Keywords:
Cerebral venous thrombosis (CVT)EfficacyEndovascular treatment (EVT)SafetyStandard care

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