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ESOC 2023 | Recanalization in cerebral venous thrombosis

Thalia Field, MD, FRCPC, MHSc, University of British Columbia in Vancouver, Canada, discusses recanalization in cerebral venous thrombosis (CVT). Unlike in acute ischemic stroke, where recanalization should happen as quickly as possible, the clinical significance of recanalization in patients with CVT is more uncertain. There are currently no studies demonstrating that recanalization leads to better functional outcomes. Moreover, recanalization is a high-risk procedure due to absence of standardized approaches, lack of tools which are designed for the venous sinuses, and limited operator experience given the rarity of the disease. Although, one study by Aguiar de Sousa et al. does provide evidence regarding the benefit of recanalization in CVT patients. This prospective neuroimaging study followed patients up after one week of anticoagulation, followed with imaging at 90 days. The study determined that at one week, patients who achieved early recanalization displayed lower risk of enlargement of existing lesions and further damage. Functional outcomes at 90 days were not statistically different for patients achieving recanalization, although this not a primary aim of the study. Meta-analysis data also supports recanalization in patients with CVT. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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Thalia Field reports the following disclosures: Bayer Canada – in kind study medication; advisory board honoraria: Roche Canada, AstraZeneca, HLS Therapeutics; expert witness – Canadian medical protective association.