IntroductionAfter several uncontrolled studies and one randomized clinical trial, there is still uncertainty regarding the role of endovascular treatment (EVT) in cerebral venous thrombosis (CVT). This study aims to describe and assess different acute management strategies in the treatment of CVT.MethodsWe performed a retrospective analysis of an international two-center registry of CVT patients admitted since 2019. Good outcome was defined as a return to baseline modified Rankin scale at three months. We described and compared EVT versus no-EVT patients.ResultsWe included 61 patients. Only one did not receive systemic anticoagulation. EVT was performed in 13/61 (20%) of the cases, with a median time from diagnosis to puncture of 4.5 h (1.25–28.5). EVT patients had a higher median baseline NIHSS [6 (IQR 2–17) vs 0 (0–2.7), p = 0.002)] and a higher incidence of intracerebral hemorrhage (53.8% vs 20.3%, p = 0.03). Recanalization was achieved in 10/13 (77%) patients. Thrombectomy was performed in every case with angioplasty in 7 out of 12 patients and stenting in 3 cases. No postprocedural complication was reported. An improvement of the median NIHSS from baseline to discharge [6 (2–17) vs 1(0–3.75); p < 0.001] was observed in EVT group. A total of 31/60 patients (50.8%) had good outcomes. Adjusting to NIHSS and ICH, EVT had a non-significant increase in the odds of a good outcome [aOR 1.42 (95%CI 0.73–2.8, p = 0.307)].ConclusionsEVT in combination with anticoagulation was safe in acute treatment of CVT as suggested by NIHSS improvement. Selected patients may benefit from this treatment.

中文翻译：

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脑静脉血栓形成的紧急治疗：两个大容量中心血管内治疗的适应症、技术和结果

简介经过几项非对照研究和一项随机临床试验，血管内治疗（EVT）在脑静脉血栓（CVT）中的作用仍存在不确定性。本研究旨在描述和评估治疗 CVT 的不同急性管理策略。方法我们对自 2019 年以来入院的 CVT 患者的国际两中心登记进行回顾性分析。良好结果的定义是恢复到基线修正 Rankin 量表三级几个月。我们描述并比较了 EVT 与非 EVT 患者。结果我们纳入了 61 名患者。只有 1 例未接受全身抗凝治疗。 13/61（20%）的病例进行了 EVT，从诊断到穿刺的中位时间为 4.5 小时（1.25-28.5）。 EVT 患者的中位基线 NIHSS 较高 [6 (IQR 2-17) vs 0 (0-2.7)，p = 0.002)]，脑出血发生率较高（53.8% vs 20.3%，p = 0.03）。 10/13 (77%) 的患者实现了再通。 12 例患者中，每例均进行了血栓切除术，其中 7 例进行了血管成形术，3 例进行了支架置入术。没有报告术后并发症。 NIHSS 中位数从基线到出院的改善 [6 (2–17) vs 1(0–3.75)；在 EVT 组中观察到 p < 0.001]。总共 31/60 名患者 (50.8%) 取得了良好的结果。根据 NIHSS 和 ICH 进行调整后，EVT 获得良好结果的几率没有显着增加 [aOR 1.42 (95%CI 0.73–2.8, p = 0.307)]。 结论 EVT 联合抗凝治疗在 CVT 急性治疗中是安全的，因为NIHSS 改进建议。选定的患者可能会从这种治疗中受益。