Background <p>Endovascular treatment (EVT) is gaining popularity for the management of severe forms of cerebral venous thrombosis (CVT), but the evidence supporting its efficacy and safety is limited.</p> Methods <p>This multicenter study included patients with CVT admitted to 104 hospitals in 31 provinces/cities in China between January 2018 and June 2022. Propensity score weighting models were used to adjust baseline confounding variables to determine the association of EVT on the primary outcome of good functional status, defined as score 0 − 1 on the modified Rankin Scale after hospital discharge.</p> Results <p>Of 3063 patients identified through hospital records searches, 2774 adults [age (42 ± 15.8) years, female 50.3%] fulfilled eligibility criteria and agreed to be included, of whom 449 (16.2%) received EVT and 2325 (83.8%) received standard care. There was no significant difference between the EVT group and the standard care group in terms of the possibility of good functional recovery [weighted risk ratio = 1.00, 95% confidence interval (CI) 0.96 − 1.03]. Similarly, there was no difference in the likelihood of death at hospital discharge (weighted risk ratio = 1.91, 95% CI 0.91 − 3.68). In subgroup analysis, the possibility of good functional recovery was lower in patients with intracerebral hemorrhage (weighted risk ratio = 0.88, 95% CI 0.79 − 0.98; <i>P</i> for interaction = 0.01) and seizures (weighted risk ratio = 0.86, 95% CI 0.76 − 0.95; <i>P</i> for interaction = 0.03).</p> Conclusion <p>In this large nationwide study, EVT was not associated with improved functional outcomes compared to standard care in patients with CVT.</p>

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

  • He-Tao Bian,
  • Xia Wang,
  • Gui-You Liu,
  • Chen Zhou,
  • Ran Meng,
  • Lan Liu,
  • Jian-Gang Duan,
  • Feng Yan,
  • Chuan-Hui Li,
  • Min Li,
  • Wen Hui,
  • Xu-Xiang Zhang,
  • Dong Zhao,
  • Ya-Peng Li,
  • Qi Fang,
  • De-Zhi Kang,
  • Hong-Liang Zeng,
  • Zhi-Jian Liang,
  • Zheng-Hao Shi,
  • Wei Yue,
  • Qin-Jian Sun,
  • Gui-Sheng Chen,
  • Jian-Long Song,
  • Zhong-Rui Yan,
  • Qiu-Hong Ji,
  • Kai-Jie Wang,
  • Lu-Sha Tong,
  • Xiao Hu,
  • Wen-Feng Cao,
  • Wei Yan,
  • Rui-Jiang Gao,
  • Qi Li,
  • Jian-Yi Wang,
  • Yi Liu,
  • Bao-Jun Wang,
  • Xiao-Hua Wang,
  • Sheng-Tao Yao,
  • Ye Lang,
  • Hai-Peng Li,
  • Craig S. Anderson,
  • Xun-Ming Ji

摘要

Background

Endovascular treatment (EVT) is gaining popularity for the management of severe forms of cerebral venous thrombosis (CVT), but the evidence supporting its efficacy and safety is limited.

Methods

This multicenter study included patients with CVT admitted to 104 hospitals in 31 provinces/cities in China between January 2018 and June 2022. Propensity score weighting models were used to adjust baseline confounding variables to determine the association of EVT on the primary outcome of good functional status, defined as score 0 − 1 on the modified Rankin Scale after hospital discharge.

Results

Of 3063 patients identified through hospital records searches, 2774 adults [age (42 ± 15.8) years, female 50.3%] fulfilled eligibility criteria and agreed to be included, of whom 449 (16.2%) received EVT and 2325 (83.8%) received standard care. There was no significant difference between the EVT group and the standard care group in terms of the possibility of good functional recovery [weighted risk ratio = 1.00, 95% confidence interval (CI) 0.96 − 1.03]. Similarly, there was no difference in the likelihood of death at hospital discharge (weighted risk ratio = 1.91, 95% CI 0.91 − 3.68). In subgroup analysis, the possibility of good functional recovery was lower in patients with intracerebral hemorrhage (weighted risk ratio = 0.88, 95% CI 0.79 − 0.98; P for interaction = 0.01) and seizures (weighted risk ratio = 0.86, 95% CI 0.76 − 0.95; P for interaction = 0.03).

Conclusion

In this large nationwide study, EVT was not associated with improved functional outcomes compared to standard care in patients with CVT.