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Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review

Background: Cerebral venous sinus or vein thromboses (SVT) are treated with heparin followed by oral anticoagulation. Even after receiving the best medical treatment, numerous patients experience neurological deterioration, intracerebral hemorrhage or brain edema. Debate regarding whether endovascul...

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Autores principales: Bücke, Philipp, Hellstern, Victoria, Cimpoca, Alexandru, Cohen, José E., Horvath, Thomas, Ganslandt, Oliver, Bäzner, Hansjörg, Henkes, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319519/
https://www.ncbi.nlm.nih.gov/pubmed/35887982
http://dx.doi.org/10.3390/jcm11144215
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author Bücke, Philipp
Hellstern, Victoria
Cimpoca, Alexandru
Cohen, José E.
Horvath, Thomas
Ganslandt, Oliver
Bäzner, Hansjörg
Henkes, Hans
author_facet Bücke, Philipp
Hellstern, Victoria
Cimpoca, Alexandru
Cohen, José E.
Horvath, Thomas
Ganslandt, Oliver
Bäzner, Hansjörg
Henkes, Hans
author_sort Bücke, Philipp
collection PubMed
description Background: Cerebral venous sinus or vein thromboses (SVT) are treated with heparin followed by oral anticoagulation. Even after receiving the best medical treatment, numerous patients experience neurological deterioration, intracerebral hemorrhage or brain edema. Debate regarding whether endovascular treatment (EVT) is beneficial in such severe cases remains ongoing. This systematic review summarizes the current evidence supporting the use of EVT for SVT on the basis of case presentations, with a focus on patient selection, treatment strategies and the effects of the COVID-19 pandemic. Methods: This systemic literature review included randomized controlled trials (RCTs) and retrospective observational data analyzing five or more patients. Follow-up information (modified Rankin scale (mRS)) was required to be provided (individual patient data). Results: 21 records (n = 405 patients; 1 RCT, 20 observational studies) were identified. EVT was found to be feasible and safe in a highly selected patient cohort but was not associated with an increase in good functional outcomes (mRS 0–2) in RCT data. In observational data, good functional outcomes were frequently observed despite an anticipated poor prognosis. Conclusion: The current evidence does not support the routine incorporation of EVT in SVT treatment. However, in a patient cohort prone to poor prognosis, EVT might be a reasonable therapeutic option. Further studies determining the patients at risk, choice of methods and devices, and timing of treatment initiation are warranted.
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spelling pubmed-93195192022-07-27 Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review Bücke, Philipp Hellstern, Victoria Cimpoca, Alexandru Cohen, José E. Horvath, Thomas Ganslandt, Oliver Bäzner, Hansjörg Henkes, Hans J Clin Med Systematic Review Background: Cerebral venous sinus or vein thromboses (SVT) are treated with heparin followed by oral anticoagulation. Even after receiving the best medical treatment, numerous patients experience neurological deterioration, intracerebral hemorrhage or brain edema. Debate regarding whether endovascular treatment (EVT) is beneficial in such severe cases remains ongoing. This systematic review summarizes the current evidence supporting the use of EVT for SVT on the basis of case presentations, with a focus on patient selection, treatment strategies and the effects of the COVID-19 pandemic. Methods: This systemic literature review included randomized controlled trials (RCTs) and retrospective observational data analyzing five or more patients. Follow-up information (modified Rankin scale (mRS)) was required to be provided (individual patient data). Results: 21 records (n = 405 patients; 1 RCT, 20 observational studies) were identified. EVT was found to be feasible and safe in a highly selected patient cohort but was not associated with an increase in good functional outcomes (mRS 0–2) in RCT data. In observational data, good functional outcomes were frequently observed despite an anticipated poor prognosis. Conclusion: The current evidence does not support the routine incorporation of EVT in SVT treatment. However, in a patient cohort prone to poor prognosis, EVT might be a reasonable therapeutic option. Further studies determining the patients at risk, choice of methods and devices, and timing of treatment initiation are warranted. MDPI 2022-07-20 /pmc/articles/PMC9319519/ /pubmed/35887982 http://dx.doi.org/10.3390/jcm11144215 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Bücke, Philipp
Hellstern, Victoria
Cimpoca, Alexandru
Cohen, José E.
Horvath, Thomas
Ganslandt, Oliver
Bäzner, Hansjörg
Henkes, Hans
Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title_full Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title_fullStr Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title_full_unstemmed Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title_short Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review
title_sort endovascular treatment of intracranial vein and venous sinus thrombosis—a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319519/
https://www.ncbi.nlm.nih.gov/pubmed/35887982
http://dx.doi.org/10.3390/jcm11144215
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