Bibliographic Details
| Title: |
Cerebral Venous Thrombosis: Medical Management vs. Endovascular Therapy. |
| Authors: |
Begley, Sabrina L., White, Timothy G., Katz, Jeffrey M. |
| Source: |
Current Treatment Options in Neurology; Jun2023, Vol. 25 Issue 6, p169-185, 17p |
| Abstract: |
Purpose of review: Cerebral venous thrombosis management has significantly evolved over the past decades. While anticoagulation (AC) use is widely accepted in treating CVT, medication class and dosing paradigm remain unclear. Furthermore, the role of endovascular interventions, including thrombectomy and intrasinus thrombolytics, is undefined. We present a review of recent clinical evidence for treatment and propose areas of future study. Recent findings.: Low molecular weight heparin (LMWH) may be beneficial over standard unfractionated heparin (UFH). While limited randomized trials assessed direct oral AC (DOAC) therapy in CVT, multiple studies, including the recent ACTION-CVT and RESPECT CVT trials, suggest the safety and efficacy of DOACs over warfarin. The role of endovascular therapy remains unclear; however, evidence demonstrates relative safety and potential clinical efficacy in improving recanalization rates. Advancements in endovascular therapy will be in optimizing patient selection and the developing devices tailored to venous sinus thrombectomy. Summary: CVT treatment has significantly progressed. DOACs and endovascular rescue therapy are now utilized for efficient recanalization to minimize sequelae such as hemorrhage, venous infarction, and intracranial hypertension. However, the relative rarity of CVT has led to understudy. Thankfully, international collaborations are creating large, randomized trials and cohort studies to answer numerous outstanding questions. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
