PT  - JOURNAL ARTICLE
AU  - Senda, Atsushi
AU  - Suginaka, Hiroshi
AU  - Morishita, Koji
AU  - Fushimi, Kiyohide
TI  - Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study
AID  - 10.1136/svn-2024-003639
DP  - 2024 Nov 20
TA  - Stroke and Vascular Neurology
PG  - svn-2024-003639
4099  - http://svn.bmj.com/content/early/2024/11/20/svn-2024-003639.short
4100  - http://svn.bmj.com/content/early/2024/11/20/svn-2024-003639.full
AB  - Introduction Cerebral venous thrombosis (CVT) is a rare but serious disease. Despite anticoagulation being the cornerstone therapy, some patients experience worsening disease, necessitating alternative treatment. Endovascular treatment is an anticipated option with an uncertain clinical relevance. The aim of this study was to assess the clinical effects and efficacy of endovascular therapy and identify patient populations that may benefit from treatment.Patients and methods This retrospective study examined patient data from April 2014 to March 2022 that were extracted from a nationwide Japanese Diagnosis Procedure Combination database. The primary outcome was in-hospital mortality. The secondary outcomes included modified Rankin Scale (mRS) scores and post-hospitalisation complications of cerebral infarction and intracranial haemorrhage. Severity was adjusted using a generalised linear mixed model, and propensity-score matching was employed to compare outcomes between treatment groups.Results The study included 2901 patients; 240 patients in the endovascular treatment group were matched with 240 patients in the standard treatment group. After adjusting for background factors, endovascular treatment did not improve in-hospital mortality (adjusted OR 1.45; 95% CI 0.74 to 2.16) or the mRS score (adjusted OR 0.89, 95% CI 0.56 to 1.23). No subpopulations that could benefit from endovascular treatment were identified. Post-hospitalisation cerebral infarction and intracranial haemorrhage did not increase with endovascular treatment (0.8% in the endovascular treatment group vs 1.2% in the standard treatment group).Conclusion Endovascular treatment showed no significant benefit for patients with CVT, indicating that treatment guidelines need to be refined. Our findings can guide clinical decisions and suggest the necessity of further research on potential benefits in specific subpopulations.Data are available upon reasonable request. The datasets generated and/or analysed during the current study are not publicly available due to privacy concerns but are available from the corresponding author on reasonable request.