1. Endovascular thrombectomy for severe cerebral venous thrombosis: A comprehensive meta-analysis assessing safety and efficacy.
- Author
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Ghozy S, Orscelik A, Tolba H, Abdelghaffar M, Kobeissi H, Ghaith HS, Abbas AS, Kadirvel R, Brinjikji W, and Kallmes DF
- Abstract
Background: Cerebral sinus venous thrombosis (CSVT) has traditionally been treated medically with systemic anticoagulation. Recent advances in endovascular therapy (EVT) may represent an alternative treatment to medical therapy for CSVT. We conducted a systematic review and meta-analysis to evaluate the use of EVT for CSVT., Methods: We conducted a systematic literature review using PubMed, Embase, Scopus, and Web of Science. We included studies that reported outcomes following EVT for CSVT. The primary outcome of interest was rate of modified Rankin Scale (mRS) 0-2. Secondary outcomes of interest were rates of complete, partial, and failed recanalization, mortality, and new or expansion of hematoma. We calculated pooled rates (%) and their corresponding 95% confidence intervals (CIs)., Results: Thirty-eight studies with 682 patients were included. Rate of mRS 0-2 was 82.6% (95% CI, 75.3%-88.0%). Rate of complete recanalization was 60.9% (95% CI, 49.1%-71.5%), rate of partial recanalization was 34.2% (95% CI, 24.1%-45.9%), and rate of failed recanalization was 5.4% (95% CI, 3.1%-9.2%). Rate of mortality was 6.7% (95% CI, 4.1%-10.8%), and rate of new hematoma or expansion of hematoma was 5.1% (2.9%-8.8%)., Conclusions: In this systematic review and meta-analysis, EVT for CSVT was associated with favorable rates of mRS 0-2 and recanalization. Furthermore, EVT was associated with a promising safety profile. Future prospective, comparative studies are warranted to assess EVT for CSVT., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: D.F.K. holds equity in Nested Knowledge, Superior Medical Editors, and Conway Medical, Marblehead Medical, and Piraeus Medical. He receives grant support from MicroVention, Medtronic, Balt, and Insera Therapeutics; has served on the Data Safety Monitoring Board for Vesalio; and received royalties from Medtronic. W.B. holds equity in Nested Knowledge, Superior Medical Editors, Piraeus Medical, Sonoris Medical, and MIVI Neurovascular. He receives royalties from Medtronic and Balloon Guide Catheter Technology. He receives consulting fees from Medtronic, Stryker, Imperative Care, Microvention, MIVI Neurovascular, Cerenovus, Asahi, and Balt. He serves in a leadership or fiduciary role for MIVI Neurovascular, Marblehead Medical LLC, Interventional Neuroradiology (Editor in Chief), Piraeus Medical, and WFITN. R.K. receives research support from: Cerenovus Inc, Medtronic, Endovascular Engineering, Frontior Bio, Sensome Inc, Endomimetics, Ancure LLC, Neurogami Medical, MIVI Biosciences, Monarch Biosciences, Stryker Inc, Conway Medical, Pireus Medical, and Bionau Labs. He holds the following research grants Research Grants: NIH (R01NS076491, R44NS107111, R43NS110114, and R21NS128199) and NSF (081215707).
- Published
- 2024
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