BACKGROUND AND PURPOSE Vessel recanalization after cerebral venous thrombosis (CVT) is associated with favorable outcomes and lower mortality. Several studies examined the timing and predictors of recanalization after CVT with mixed results. We aimed to investigate predictors and timing of recanalization after CVT. METHODS We used data from the multicenter, international AntiCoagulaTION in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with CVT from January 2015 to December 2020. Our analysis included patients that had undergone repeat venous neuroimaging more than 30 days after initiation of anticoagulation treatment. Prespecified variables were included in univariate and multivariable analyses to identify independent predictors of failure to recanalize. RESULTS Among the 551 patients (mean age, 44.4±16.2 years, 66.2% women) that met inclusion criteria, 486 (88.2%) had complete or partial, and 65 (11.8%) had no recanalization. The median time to first follow-up imaging study was 110 days (interquartile range, 60-187). In multivariable analysis, older age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.03-1.07), male sex (OR, 0.44; 95% CI, 0.24-0.80), and lack of parenchymal changes on baseline imaging (OR, 0.53; 95% CI, 0.29-0.96) were associated with no recanalization. The majority of improvement in recanalization (71.1%) occurred before 3 months from initial diagnosis. A high percentage of complete recanalization (59.0%) took place within the first 3 months after CVT diagnosis. CONCLUSION Older age, male sex, and lack of parenchymal changes were associated with no recanalization after CVT. The majority recanalization occurred early in the disease course suggesting limited further recanalization with anticoagulation beyond 3 months. Large prospective studies are needed to confirm our findings.

中文翻译：

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脑静脉血栓形成抗凝后再通的时间和预测因素。

背景和目的 脑静脉血栓形成 (CVT) 后的血管再通与良好的结果和较低的死亡率相关。几项研究检查了 CVT 后再通的时间和预测因素，结果不一。我们的目的是调查 CVT 后再通的预测因子和时间。方开始抗凝治疗。单变量和多变量分析中包含预先指定的变量，以确定再通失败的独立预测因子。结果 在 551 名患者中（平均年龄，44.4±16. 2 年，66.2% 女性）符合纳入标准，486 人（88.2%）有完全或部分再通，65 人（11.8%）没有再通。首次随访影像学研究的中位时间为 110 天（四分位距，60-187）。在多变量分析中，年龄较大（比值比 [OR]，1.05；95% 置信区间 [CI]，1.03-1.07）、男性（OR，0.44；95% CI，0.24-0.80）和缺乏实质变化基线成像（OR，0.53；95% CI，0.29-0.96）与无再通相关。大部分再通改善 (71.1%) 发生在初始诊断后 3 个月内。CVT 诊断后的前 3 个月内发生了很高比例的完全再通 (59.0%)。结论 高龄、男性和无实质改变与 CVT 后无再通有关。大多数再通发生在疾病过程的早期，这表明超过 3 个月的抗凝进一步再通有限。需要大型前瞻性研究来证实我们的发现。