Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy

Araúz, Antonio; Vargas-González, Juan-Camilo; Arguelles-Morales, Nayelli; Barboza, Miguel A; Calleja, Juan Manuel; Martínez-Jurado, Elizabeth; Ruíz-Franco, Angélica; Quiroz-Compean, Alejandro; Merino, José G.

doi:10.1136/jnnp-2014-310068

Cited by 56 publications

(67 citation statements)

References 15 publications

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“…We confirmed that patients with full recanalization have a better functional outcome. Similar data were published recently by Arouz et al [17]. These patients are also younger; more often female and taking contraceptive pills (if female).…”

Section: Citationsupporting

confidence: 77%

“…These patients are also younger; more often female and taking contraceptive pills (if female). Recanalization occurs mainly in the first 3-4 month after thrombosis but can happen within the first year from diagnosis [17,18]. It might be important to extend anticoagulation treatment (usually with LMWH or warfarin) till 1 year in cases where only partial or none recanalization was observed [11,19].…”

Section: Citationmentioning

confidence: 99%

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Risk and Prognostic Factors in Cerebral Venous Thrombosis

Košťál¹,

Krajíčková²,

Ivanová³

et al. 2017

J Hematol Thrombo Dis

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Objective and design: Cerebral venous thrombosis (CVT) differs from deep venous thrombosis (DVT) in prognosis, risk factors and treatment. We analyzed data gathered in our prospective CVT single-center registry in search of risk and prognostic factors. Data from 73 patients were available.Results: JAK2 mutation (11%) and Leiden mutation of factor V (11%) were the most common among genetic risk factors. The most common acquired risk factor was the use of combined hormonal contraception (COC) or hormonal replacement therapy (HRT) in 64% of female patients. No specific cause was found in 22% of cases. Complete recanalization was present in 44% of cases, more often in female than in male (p=0.0287) and in younger patients (p=0.045). We found final mRS score one and higher in 29% of patients. These patients did not use COC/HRT (p=0.021) or did not achieve complete recanalization (p=0.0058). Patients with higher mRS score tend to be older (p=0.081).Conclusions: COC/HRT use and complete recanalization can be considered when adjusting the length of anticoagulation therapy. JAK2 mutation should be screened in all patients with CVT.

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Section: Citationsupporting

confidence: 77%

Section: Citationmentioning

confidence: 99%

Risk and Prognostic Factors in Cerebral Venous Thrombosis

Košťál¹,

Krajíčková²,

Ivanová³

et al. 2017

J Hematol Thrombo Dis

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“…Finally, we selected 19 studies. [4][5][6][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] A MOOSE/PRISMA flowchart summarizes study selection, including the reasons for exclusion (Figure 1). Details of the studies are displayed in the Table. The 19 studies included a total of 818 patients with recanalization data after CVT ranging from 10 to 125 patients per study.…”

Section: Resultsmentioning

confidence: 99%

“…3 Importantly, studies assessing the relationship between venous recanalization and prognosis in patients with CVT have shown conflicting results. [4][5][6] One possible explanation could be the variable extent and function of collateral circulation, which was not analyzed in these cohorts. However, an independent effect of venous collateral circulation on the prognosis of patients with CVT has not been shown previously.…”

mentioning

confidence: 99%

Recanalization in Cerebral Venous Thrombosis

Sousa¹,

Neto

Canhão

et al. 2018

Stroke

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Background and Purpose-The role of recanalization of the occluded dural sinus or vein in the outcome of patients with cerebral venous thrombosis (CVT) is not established. We aimed to systematically review, in patients with CVT, (1) the recanalization rate and its association with (2) clinical outcome and (3) CVT recurrence. Methods-Systematic search in MEDLINE (Medical Literature Analysis and Retrieval System Online), Cochrane Library, and clinicaltrials.gov (inception to September 2017). We considered cohort studies reporting the recanalization rate in adult patients with CVT treated with anticoagulation. Reported rates of venous recanalization at the last follow-up, functional outcome defined using the modified Rankin Scale at last follow-up dichotomized for favorable (0-1) and unfavorable (2-6) outcome, and recurrence rate of CVT according to recanalization status were extracted independently by 2 authors. Meta-analyses of proportions were performed using Freeman-Tukey double arcsine transformation. Functional outcomes according to the recanalization status were compared using meta-analysis and ordinal logistic regression. We conducted sensitivity analyses for time to assessment of recanalization and study quality. Results-Four hundred sixty-eight studies were identified, and 19 studies were included. (1) We found report of 694 patients with recanalization in the follow-up among 818 cases of CVT. The overall pooled proportion of patients achieving recanalization was 85% (95% confidence interval, 80-89; I 2 =58%). In studies with higher methodological quality, the recanalization rate was 77% (95% confidence interval, 70-82; I 2 =0%). (2) There was a significant increase in the chance of favorable outcome (modified Rankin Scale, 0-1) in patients with recanalization with a pooled odds ratio of 3.3 (95% confidence interval, 1.2-8.9; I 2 =32%) in the random effects meta-analysis and a common odds ratio of 3.3 (95% confidence interval, 1.7-6.3) in the ordinal logistic regression. (3) Data on CVT recurrence according to recanalization was scarce. Conclusions-The overall rate of recanalization in patients receiving anticoagulation was 85%, but exclusion of severe patients from follow-up imaging is a plausible source of bias. Lack of venous recanalization was associated with worse clinical outcome.

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“…Low-molecular-weight heparin was found to be superior to unfractionated heparin (37). It has been shown that recanalization starts after 3 months and increases within the first 12 months at various rates (38). It has been suggested that anticoagulation should be continued for 6 months with vitamin K antagonists after the acute phase (22,39,40).…”

Section: Treatmentmentioning

confidence: 99%

The Diagnosis and Treatment of Cerebral Venous Thrombosis

Kaya¹

2017

tnd

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Serebral venöz sinüs trombozu, dural sinüslerin ve/veya venlerin trombozunu içerir. Tüm inmelerin %0,5-1'ini oluşturur ve genellikle gençlerde görülür. Gebelik, puerperyum ve oral kontraseptif kullanımı nedeni ile genç kadınlarda biraz daha fazla görülmektedir. Hastalar genellikle baş ağrısı veya fokal nörolojik defisit nedeni ile başvurur. En sık superior sagittal sinüs etkilenir. Sinüslerin atrezisi/hipoplazisi, asimetrik sinüs drenajı gibi venöz anatomideki varyasyonlar sinüs trombozunu taklit edebilir. Genel olarak manyetik rezonans görüntüleme kullanımı bilgisayarlı tomografi kullanımına göre trombozun tüm dönemlerinde tanı için daha duyarlıdır. Tedavide ilk tercih edilecek ilaç grubu antikoagülanlardır. Anahtar Kelimeler: Antikoagülasyon, tromboz, venöz sinüsCerebral venous sinus thrombosis involves thrombosis of the dural sinuses and/or cerebral veins. It constitutes 0.5-1% of all strokes and usually affects young individuals. It is slightly more common in young women due to pregnancy, puerperium, and oral contraceptive use. Patients usually present with headache or focal neurologic deficits. The superior sagittal sinus is most frequently affected sinus. Variations in venous anatomy, such as atresia/hypoplasia of the sinuses or asymmetric drainage of the sinus, may mimic sinus thrombosis. In general, magnetic resonance imaging is more sensitive than computed tomography in the detection of cerebral venous sinus thrombosis at each stage. Anticoagulants are the first preferred group of drugs in the treatment.

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Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy

Abstract: We found that recanalisation occurs over time, until month 11. Complete recanalisation may influence functional outcome.

Cited by 56 publications

References 15 publications

Risk and Prognostic Factors in Cerebral Venous Thrombosis

Risk and Prognostic Factors in Cerebral Venous Thrombosis

Recanalization in Cerebral Venous Thrombosis

The Diagnosis and Treatment of Cerebral Venous Thrombosis

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