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Open Access

Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study

Atsushi Senda, Hiroshi Suginaka, Koji Morishita, Kiyohide Fushimi
DOI: 10.1136/svn-2024-003639 Published 20 November 2024
Atsushi Senda
1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
2Toda Chuo General Hospital, Toda, Saitama, Japan
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Hiroshi Suginaka
2Toda Chuo General Hospital, Toda, Saitama, Japan
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Koji Morishita
1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Kiyohide Fushimi
3Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Figures

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  • Figure 1
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    Figure 1

    Flow diagram of the patient selection process.

  • Figure 2
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    Figure 2

    Comparison of outcomes between the endovascular and standard treatment groups. (A) Forest plot comparing in-hospital mortality and mRS score between the endovascular and standard treatment groups (X-axis is presented in log scale). (B) mRS score at the time of discharge. GLMM, generalised linear mixed model; mRS, modified Rankin Scale; PSM, propensity-score matching.

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    Figure 3

    Comparison of outcome among groups classified by disease severity. Severity is stratified using the prediction model, while treatment effects are estimated using the propensity score matching. X-axis is presented in log scale. mRS, modified Rankin Scale.

  • Figure 4
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    Figure 4

    Comparison of outcome among groups categorised by year of admission. Treatment effects are estimated using a generalised linear mixed model. X-axis is presented in log scale. mRS, modified Rankin Scale.

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    Figure 5

    (A) Comparison of outcome in the subpopulation of patients aged <50 years and patients aged ≥50 years. (B) Comparison of outcomes between male and female patients. Treatment effects are estimated using a generalised linear mixed model. X-axis is presented in log scale. mRS, modified Rankin Scale.

Tables

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  • Table 1

    Patient characteristics

    Standard treatmentEndovascular treatment
    N2659242
    Age, years (mean (SD))54.52 (18.47)53.17 (18.33)
    Female sex (%)1322 (49.7)121 (50.0)
    Charlson Comorbidity Index (%)
     0482 (62.0)78 (70.9)
     1135 (17.4)13 (11.8)
     262 (8.0)6 (5.5)
     345 (5.8)5 (4.5)
     430 (3.9)6 (5.5)
     519 (2.4)2 (1.8)
     65 (0.6)0 (0.0)
     72 (0.1)0 (0.0)
     81 (0.0)0 (0.0)
    State of consciousness
     Alert (%)1488 (56.0)85 (35.1)
     Coma (%)174 (6.5)35 (14.5)
     Subarachnoid haemorrhage (%)130 (4.9)15 (6.2)
     Intracranial haemorrhage (%)4 (0.2)0 (0.0)
     Cerebral infarction (%)8 (0.3)2 (0.8)
     Acute renal failure (%)13 (0.5)1 (0.4)
     Heart failure (%)66 (2.5)4 (1.7)
     Use of warfarin (%)1481 (55.7)118 (48.8)
     Use of other anticoagulants (%)528 (19.9)72 (29.8)
     Use of antiepileptic drugs (%)815 (30.7)143 (59.1)
     Use of antihypertensive drugs (%)607 (22.8)154 (63.6)
    • SD, standard deviation.

  • Table 2

    Patient characteristics after 1:1 propensity-score matching

    Standard treatmentEndovascular treatmentSMD
    N240240
    Age, years (mean (SD))53.88 (17.57)53.27 (18.37)0.034
    Female sex (%)123 (51.2)120 (50.0)0.025
    Charlson Comorbidity Index (%)0.187
     076 (31.7)71 (29.6)
     173 (30.4)80 (33.3)
     251 (21.2)53 (22.1)
     324 (10.0)26 (10.8)
     410 (4.2)7 (2.9)
     53 (1.2)3 (1.2)
     63 (1.2)0 (0.0)
    State of consciousness
     Alert (%)84 (35.0)85 (35.4)0.009
     Coma (%)33 (13.8)35 (14.6)0.024
     Subarachnoid haemorrhage (%)24 (10.0)15 (6.2)0.138
     Intracranial haemorrhage (%)69 (28.7)71 (29.6)0.018
     Cerebral infarction (%)86 (35.8)78 (32.5)0.07
     Acute renal failure (%)1 (0.4)1 (0.4)<0.001
     Heart failure (%)7 (2.9)4 (1.7)0.084
     Use of warfarin (%)122 (50.8)118 (49.2)0.033
     Use of other anticoagulants (%)72 (30.0)70 (29.2)0.018
     Use of antiepileptic drugs (%)136 (56.7)141 (58.8)0.042
     Use of antihypertensive drugs (%)153 (63.7)152 (63.3)0.009
    • SMD, standardised mean difference.

  • Table 3

    Patient characteristics after 1:3 propensity-score matching

    Standard treatmentEndovascular treatmentSMD
    N240720
    Age, years (mean (SD))53.88 (17.57)53.68 (18.51)<0.001
    Female sex (%)123 (51.2)368 (51.1)0.018
    Charlson Comorbidity Index (%)0.156
     076 (31.7)223 (31.0)
     172 (39.9)236 (32.8)
     251 (21.2)158 (21.9)
     324 (10.0)75 (10.4)
     410 (4.2)20 (2.8)
     53 (1.2)6 (0.8)
     63 (1.2)2 (1.7)
    State of consciousness
     Alert (%)84 (35.0)268 (37.2)0.019
     Coma (%)33 (13.8)97 (13.5)0.024
     Subarachnoid haemorrhage (%)24 (10.0)81 (11.3)0.012
     Intracranial haemorrhage (%)69 (28.7)213 (29.6)0.022
     Cerebral infarction (%)86 (35.8)278 (38.6)0.010
     Acute renal failure (%)1 (0.4)3 (0.4)<0.001
     Heart failure (%)7 (2.9)12 (1.7)0.087
     Use of warfarin (%)122 (50.8)355 (49.3)0.059
     Use of other anticoagulants (%)72 (30.0)207 (28.8)0.013
     Use of antiepileptic drugs (%)136 (56.7)400 (55.6)0.006
     Use of antihypertensive drugs (%)153 (63.7)436 (60.6)0.006
    • SD, standard deviation; SMD, standardised mean difference.

Supplementary Materials

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  • Supplementary data

    [svn-2024-003639supp001.pdf]

Additional Files

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  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Data supplement 1
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Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study
Atsushi Senda, Hiroshi Suginaka, Koji Morishita, Kiyohide Fushimi
Stroke and Vascular Neurology Nov 2024, svn-2024-003639; DOI: 10.1136/svn-2024-003639

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Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study
Atsushi Senda, Hiroshi Suginaka, Koji Morishita, Kiyohide Fushimi
Stroke and Vascular Neurology Nov 2024, svn-2024-003639; DOI: 10.1136/svn-2024-003639
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Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study
Atsushi Senda, Hiroshi Suginaka, Koji Morishita, Kiyohide Fushimi
Stroke and Vascular Neurology Nov 2024, svn-2024-003639; DOI: 10.1136/svn-2024-003639
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