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

Autor:	Brakel BA; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Rebchuk AD; Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada., Ospel J; Department of Radiology, University of Calgary, Calgary, AB, Canada.; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada., Chen Y; Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China., Heran MK; Department of Radiology, University of British Columbia, Vancouver, BC, Canada., Goyal M; Department of Radiology, University of Calgary, Calgary, AB, Canada.; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada., Hill MD; Department of Radiology, University of Calgary, Calgary, AB, Canada.; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada., Miao Z; Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Huo X; Neurological Disease Center, Beijing Anzhen Hospital, Beijing, China., Sacco S; Neuroscience Section, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Yaghi S; Department of Neurology, Brown University, Providence, RI, USA., Mai TD; Stroke Centre, Bach Mai Hospital, Ha Noi Medical University, Hanoi, Vietnam.; VNU University of Medicine and Pharmacy, Hanoi, Vietnam., Thomalla G; Department of Neurology, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany., Boulouis G; Departments of Diagnostic and Interventional Neuroradiology, University of Tours, Tours, France., Yamagami H; Department of Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan., Hu W; Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Anhui, China., Nagel S; Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany., Puetz V; Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.; Dresden Neurovascular Center, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany., Kristoffersen ES; Department of Neurology, Akershus University Hospital, Lørenskog, Norway., Demeestere J; Department of Neurology, Leuven University Hospital, Leuven, Belgium., Qiu Z; Department of Neurology, The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China., Abdalkader M; Department of Neurology, Radiology, Boston University School of Medicine, Boston, MA, USA., Al Kasab S; Department of Neurology, Medical University of South Carolina, Charleston, SC, USA., Siegler JE; Department of Neurology, University of Chicago, Chicago, IL, USA., Strbian D; Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Fischer U; Department of Neurology, University Hospital Bern, University of Bern, Switzerland., Coutinho JM; Department of Neurology, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands., van de Munckhof A; Department of Neurology, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands., Aguiar de Sousa D; Stroke center, Lisbon Central University Hospital - ULS S José, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.; L Lopes lab, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal., Campbell B; Department of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia., Raymond J; Department of Radiology, Service of Interventional Neuroradiology, Université de Montréal, Montreal, QC, Canada., Ji X; Department of Neurosurgery, Xuanwu Hospital, Beijing, China., Saposnik G; Stroke Outcomes Research & Decision Neuroscience Unit, Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada., Nguyen TN; Department of Neurology, Radiology, Boston University School of Medicine, Boston, MA, USA., Field TS; Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Jazyk:	angličtina
Zdroj:	International journal of stroke : official journal of the International Stroke Society [Int J Stroke] 2024 Nov 21, pp. 17474930241304206. Date of Electronic Publication: 2024 Nov 21.
DOI:	10.1177/17474930241304206
Abstrakt:	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-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 three years, 56% of respondents used EVT for the treatment of CVT, with most (49.5%) involved in 2-5 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 predominately 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. Conclusions: 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.
Databáze:	MEDLINE
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