Efficacy of systemic anticoagulation combined with endovascular treatment for cerebral venous sinus thrombosis

Abstract:

Objective To observe and evaluate the clinical efficacy of systemic anticoagulation combined with endovascular treatment of cerebral venous sinus thrombosis（CVST）.Methods CVST patients who were treated in our hospital from June 2008 to August 2021 were retrospectively enrolled，and divided into anticoagulation treatment（AT）group and endovascular treatment（EVT）group according to different treatment methods. Additionally，the clinical data and treatment effects of the two groups were analyzed.Results A total of 54 patients were enrolled, including 27 patients in the AT group and 27 patients in the EVT group. Compared with the AT group, the proportion of patients with thrombosis involving superior sagittal sinus and straight sinus, amount of involved sinus and modified Rankin scale (mRS) scores of patients were significantly higher in EVT group（P<0.05）. After treatment，prothrombin time and activated partial thrombin time in two groups were significantly increased，and the level of D-dimer in AT group was significantly reduced（P<0.05）. The recanalization rate of the EVT group was significantly higher than that of the AT group（P<0.05），and there were no significant differences in total duration of hospital stay，duration of ICU stays，incidence of complications，survival rate and neurological prognosis between the EVT group and the AT group（P>0.05）. The mRS scores of patients after treatment were significantly lower than those before treatment in both groups（P<0.05）.Conclusion For severe CVST patients with extensive thrombus involvement and poor anticoagulant efficacy，standard anticoagulant therapy combined with endovascular treatment could be a safe and effective potential option.