Bücke, Philipp; Hellstern, Victoria; Cimpoca, Alexandru; Cohen, José E; Horvath, Thomas; Ganslandt, Oliver; Bäzner, Hansjörg; Henkes, Hans (2022). Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis-A Systematic Review. Journal of clinical medicine, 11(14) MDPI 10.3390/jcm11144215
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BACKGROUND
Cerebral venous sinus or vein thromboses (SVT) are treated with heparin followed by oral anticoagulation. Even after receiving the best medical treatment, numerous patients experience neurological deterioration, intracerebral hemorrhage or brain edema. Debate regarding whether endovascular treatment (EVT) is beneficial in such severe cases remains ongoing. This systematic review summarizes the current evidence supporting the use of EVT for SVT on the basis of case presentations, with a focus on patient selection, treatment strategies and the effects of the COVID-19 pandemic.
METHODS
This systemic literature review included randomized controlled trials (RCTs) and retrospective observational data analyzing five or more patients. Follow-up information (modified Rankin scale (mRS)) was required to be provided (individual patient data).
RESULTS
21 records (n = 405 patients; 1 RCT, 20 observational studies) were identified. EVT was found to be feasible and safe in a highly selected patient cohort but was not associated with an increase in good functional outcomes (mRS 0-2) in RCT data. In observational data, good functional outcomes were frequently observed despite an anticipated poor prognosis.
CONCLUSION
The current evidence does not support the routine incorporation of EVT in SVT treatment. However, in a patient cohort prone to poor prognosis, EVT might be a reasonable therapeutic option. Further studies determining the patients at risk, choice of methods and devices, and timing of treatment initiation are warranted.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Bücke, Philipp Jonas, Horvath, Thomas Nikolaus |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2077-0383 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
02 Aug 2022 08:14 |
Last Modified: |
05 Dec 2022 16:22 |
Publisher DOI: |
10.3390/jcm11144215 |
PubMed ID: |
35887982 |
Uncontrolled Keywords: |
VITT anticoagulation cerebral venous sinus thrombosis endovascular therapy intracerebral hemorrhage thrombectomy thrombolysis |
BORIS DOI: |
10.48350/171601 |
URI: |
https://boris.unibe.ch/id/eprint/171601 |
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