International practice patterns and perspectives on endovascular therapy for the treatment of cerebral venous thrombosis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Benjamin A Brakel - , University of British Columbia (Author)
  • Alexander D Rebchuk - , University of British Columbia (Author)
  • Johanna Ospel - , University of Calgary (Author)
  • Yimin Chen - , Southern Medical University (Author)
  • Manraj Ks Heran - , University of British Columbia (Author)
  • Mayank Goyal - , University of Calgary (Author)
  • Michael D Hill - , University of Calgary (Author)
  • Zhongrong Miao - , Beijing Tiantan Hospital (Author)
  • Xiaochuan Huo - , Capital Medical University (CMU) (Author)
  • Simona Sacco - , University of L'Aquila (Author)
  • Shadi Yaghi - , Brown University (Author)
  • Ton Duy Mai - , VNU University of Medicine and Pharmacy (Author)
  • Götz Thomalla - , University Hospital Hamburg Eppendorf (Author)
  • Grégoire Boulouis - , Université de Tours (Author)
  • Hiroshi Yamagami - , National Hospital Organization Osaka Medical Center (Author)
  • Wei Hu - , The First Affiliated Hospital of USTC China (Author)
  • Simon Nagel - , Klinikum Ludwigshafen (Author)
  • Volker Puetz - , Department of Neurology, Dresden Neurovascular Center, University Hospital Carl Gustav Carus Dresden (Author)
  • Espen Saxhaug Kristoffersen - , Akershus University Hospital (Ahus) (Author)
  • Jelle Demeestere - , University Hospitals Leuven (Author)
  • Zhongming Qiu - , The 903rd Hospital of the Chinese People's Liberation Army (Author)
  • Mohamad Abdalkader - , Boston University (Author)
  • Sami Al Kasab - , Medical University of South Carolina (Author)
  • James E Siegler - , The University of Chicago (Author)
  • Daniel Strbian - , Helsinki University Hospital (HUS) (Author)
  • Urs Fischer - , Inselspital University Hospital Bern (Author)
  • Jonathan Coutinho - , Amsterdam University Medical Centers (UMC) (Author)
  • Anita Munckhof - , Amsterdam University Medical Centers (UMC) (Author)
  • Diana Aguiar de Sousa - , University of Lisbon (Author)
  • Bruce Cv Campbell - , Royal Melbourne Hospital (Author)
  • Jean Raymond - , Centre Hospitalier de l'Université de Montreal (CHUM) (Author)
  • Xunming Ji - , Xuanwu Hospital of Capital Medical University (Author)
  • Gustavo Saposnik - , University of Toronto (Author)
  • Thanh N Nguyen - , Boston University (Author)
  • Thalia S Field - , University of British Columbia (Author)

Abstract

BACKGROUND: Cerebral venous thrombosis (CVT) accounts for 0.5-1% of all strokes. The role of endovascular therapy (EVT) in the management of CVT remains controversial and variations in practice patterns are not well known.

AIMS: Here, we present a comprehensive, international characterization of practice patterns and perspectives on the use of EVT for CVT.

METHODS: A comprehensive 42-question survey was distributed to stroke clinicians globally from May to October 2023, asking about practice patterns and perspectives on the use of EVT for CVT.

RESULTS: The overall response rate was 31% (863 respondents of 2744 invited) across 61 countries. The majority of respondents (74%) supported the use of EVT for CVT in certain clinical situations. Key considerations for decision-making in using EVT favored clinical over radiographic/procedural factors and included worsening level of consciousness (86%) and worsening neurological deficits (76%). In the past 3 years, 56% of respondents used EVT for the treatment of CVT, with most (49.5%) involved in two to five cases. Among interventionalists, significant variability existed in the techniques used for EVT (p < 0.001), with aspiration thrombectomy (56%) and stent retriever (51%) being the most used overall. Regionally, interventionalists from China predominantly used intra-sinus heparin (56%), while this technique was most commonly ranked as "never indicated" throughout the rest of the world (23%). Post-procedure, low molecular weight heparin was the most used anticoagulant (83%), although North American respondents favored unfractionated heparin (37%), while imaging was primarily split between magnetic resonance (71.8%) and computed tomography (65.9%) arteriography or venography.

CONCLUSION: Our survey reveals significant heterogeneity in approaches to EVT for CVT, and provides a comprehensive characterization of indications, techniques, and long-term management used by clinicians internationally. This resource will aid in optimizing patient selection and endovascular treatments for future trials.

Details

Original languageEnglish
JournalInternational Journal of Stroke
Publication statusE-pub ahead of print - 17 Dec 2024
Peer-reviewedYes

External IDs

Scopus 85212235452