Oral Direct Thrombin Inhibitor as an Alternative in the Management of Cerebral Venous Thrombosis: A Series of 15 Patients

Mendonça, M.; Barbosa, Raquel; Cruz-e-Silva, Vera; Calado, Sofia; Viana-Baptista, Miguel

doi:10.1111/ijs.12462

Cited by 68 publications

(89 citation statements)

References 12 publications

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“…34 However, for CVT, there are only a few observational studies available, with one of the largest involving just 15 patients. 35 In the absence of clear evidence, DOACs remain a potential treatment option in patients for whom warfarin is not suitable, but would not be recommended as a first-line therapy.…”

Section: Management Of Cvtmentioning

confidence: 99%

Diagnosis and management of cerebral venous thrombosis

Behrouzi

Punter

2018

Clinical Medicine

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Cerebral venous thrombosis (CVT) is rare and accounts for 0.5% of all strokes. Its clinical presentation is variable and diagnosis requires a high index of clinical suspicion in conjunction with neuroradiological diagnostic support. Treatment options are limited and are mostly based on consensus. Therefore, familiarity with international guidelines is important. Outcome is often good and most patients make a full recovery, although a small proportion suffers death or disability. Here, we describe the clinical features, risk factors, acute imaging features, management and complications of CVT.

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Section: Management Of Cvtmentioning

confidence: 99%

Diagnosis and management of cerebral venous thrombosis

Behrouzi

Punter

2018

Clinical Medicine

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“…The most recent study evaluated 15 cases of CVT treated with dabigatran after the acute phase; no cases of recurrence or of hemorrhagic complications were reported. In about 20% of cases patients did not achieve reperfusion; however, in all instances, this was deemed related to old age or non-modifiable risk factors such as cancer and lupus [7]. The second study evaluated the use of rivaroxaban in the acute treatment of CVT and found no significant recurrences or complications during 8 months of follow-up [8].…”

Section: Discussionmentioning

confidence: 99%

Dabigatran in the Treatment of Extensive Cerebral Venous Thrombosis: A Case Report

Vedana¹,

Marrone²,

Missima³

et al. 2018

WJNS

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Background: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease associated with a 15% rate of death or function dependence. The mainstay of treatment for CVT is systemic anticoagulation, despite venous hemorrhagic infarction. Vitamin K antagonists have long been the only available option for anticoagulation; however, the past few years have brought the development of many new target-specific drugs, collectively called non-vitamin K antagonist oral anticoagulants (NOACs). Although emerging evidence suggests NOACs have an acceptable safety and tolerability profile in CVT, there are limited data available and no randomized controlled trials have been performed to date. Case Presentation: This describes the case of a patient with CVT occurring during an infection who was successfully treated with a NOAC, dabigatran, after a difficult time on warfarin. Conclusions: A case of extensive and deep CVT was identified. Dabigatran 150 mg treatment twice daily in this patient resulted in no additional damage to the brain. This case study illustrates that the use of NOACs such as dabigatran can be safe and effective in patients with CVT.

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“…There have been some case reports of cerebral sinus thrombosis being treated with dabigatran, rivaroxaban or edoxaban [7][8][9][10]. However, none of these case reports were randomized controlled trials.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Cerebral Sinus Thrombosis with Edoxaban Alone

Shibata¹

2017

Int J Crit Care Emerg Med

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Oral Direct Thrombin Inhibitor as an Alternative in the Management of Cerebral Venous Thrombosis: A Series of 15 Patients

Cited by 68 publications

References 12 publications

Diagnosis and management of cerebral venous thrombosis

Diagnosis and management of cerebral venous thrombosis

Dabigatran in the Treatment of Extensive Cerebral Venous Thrombosis: A Case Report

Successful Treatment of Cerebral Sinus Thrombosis with Edoxaban Alone

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