Academic Journal
Early Versus Late Initiation of Endovascular Therapy in Patients with Severe Cerebral Venous Sinus Thrombosis
| Τίτλος: | Early Versus Late Initiation of Endovascular Therapy in Patients with Severe Cerebral Venous Sinus Thrombosis |
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| Συγγραφείς: | Philipp Bücke, Hans Henkes, Johannes Kaesmacher, Mirjam R. Heldner, Adrian Scutelnic, Marcel Arnold, Thomas R. Meinel, Alexandru Cimpoca, Thomas Horvath, Elina Henkes, Hansjörg Bäzner, Victoria Hellstern |
| Πηγή: | Neurocrit Care Bücke, Philipp; Henkes, Hans; Kaesmacher, Johannes; Heldner, Mirjam R; Scutelnic, Adrian; Arnold, Marcel; Meinel, Thomas R; Cimpoca, Alexandru; Horvath, Thomas; Henkes, Elina; Bäzner, Hansjörg; Hellstern, Victoria (2024). Early Versus Late Initiation of Endovascular Therapy in Patients with Severe Cerebral Venous Sinus Thrombosis. (In Press). Neurocritical care Springer 10.1007/s12028-024-02046-7 <http://dx.doi.org/10.1007/s12028-024-02046-7> Bücke, Philipp; Henkes, Hans; Kaesmacher, Johannes; Heldner, Mirjam R; Scutelnic, Adrian; Arnold, Marcel; Meinel, Thomas R; Cimpoca, Alexandru; Horvath, Thomas; Henkes, Elina; Bäzner, Hansjörg; Hellstern, Victoria (2024). Early Versus Late Initiation of Endovascular Therapy in Patients with Severe Cerebral Venous Sinus Thrombosis. Neurocritical care, 41(3), pp. 1047-1054. Springer 10.1007/s12028-024-02046-7 <http://dx.doi.org/10.1007/s12028-024-02046-7> |
| Στοιχεία εκδότη: | Springer Science and Business Media LLC, 2024. |
| Έτος έκδοσης: | 2024 |
| Θεματικοί όροι: | Adult, Male, Endovascular Procedures, Medizin, 610 Medicine & health, Middle Aged, Time-to-Treatment, 3. Good health, Young Adult, Sinus Thrombosis, Intracranial, Humans, Female, Hospital Mortality, Registries, Female [MeSH], Endovascular Procedures/methods [MeSH], Adult [MeSH], Humans [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Time-to-Treatment [MeSH], Hospital Mortality [MeSH], Original Work, Male [MeSH], Sinus thrombosis, Thrombectomy, Young Adult [MeSH], Intracerebral hemorrhage, Registries [MeSH], Sinus Thrombosis, Intracranial/therapy [MeSH], Retrospective Studies |
| Περιγραφή: | Background Endovascular therapy (EVT) for severe cerebral venous sinus thrombosis (CVST) is controversial in terms of indication and clinical benefit. The impact of delay of EVT on functional recovery is unclear. This study aimed to investigate the effect of early versus late initiation of EVT in severe CVST. Methods From prospective EVT and CVST registries, patients with CVST diagnosed between January 2010 and December 2022 were retrospectively identified for this multicenter collaboration. EVT was considered in severe CVST with features prone to a poor prognosis. We compared early ( 24 h) initiation of EVT after the presentation in the emergency department and subsequent CVST diagnosis. Outcome parameters included functional independence (modified Rankin Scale [mRS] score 0–2) at 90 days, mRS score at discharge, in-hospital mortality, and mortality at 3 months. Results Of 363 patients with CVST, 45 (12.4%; 31 [early EVT] vs. 14 [late EVT]) were included in this study. We found a higher proportion of patients with functional independence at 3 months among early versus late EVT (66.7% vs. 27.3%; odds ratio [OR] 5.3; 95% confidence interval 1.02–25; p = 0.036). In multivariate logistic regression, late EVT was inversely correlated with functional independence (OR 0.17 [0.04–0.83]; p = 0.011). The mortality rate was 16.7% versus 36.4% (mRS 6 at 3 months, OR 0.34, 95% confidence interval 0.07–1.75; p = 0.217) at 90 days for early versus late EVT. Conclusions We observed a higher rate of functional independence in patients with early EVT. These preliminary findings must be confirmed in subsequent randomized controlled trials evaluating a “time-is-brain” paradigm for EVT in CVST. |
| Τύπος εγγράφου: | Article Other literature type |
| Περιγραφή αρχείου: | application/pdf |
| Γλώσσα: | English |
| ISSN: | 1556-0961 1541-6933 |
| DOI: | 10.1007/s12028-024-02046-7 |
| DOI: | 10.48350/199164 |
| Σύνδεσμος πρόσβασης: | https://pubmed.ncbi.nlm.nih.gov/39042279 https://boris.unibe.ch/199164/ https://repository.publisso.de/resource/frl:6496151 |
| Rights: | CC BY |
| Αριθμός Καταχώρησης: | edsair.doi.dedup.....7d97f7854f898534eadc7e9616a6ecff |
| Βάση Δεδομένων: | OpenAIRE |
| ISSN: | 15560961 15416933 |
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| DOI: | 10.1007/s12028-024-02046-7 |