WSC 2025 | The indications for endovascular thrombectomy in patients with CVT

So previous studies, and these are also sort of guideline recommendations, saved EVT for patients who kept deteriorating despite best medical therapy with heparins and then oral anticoagulants, and also patients who had more severe forms of CVT with reduced level of consciousness and Glasgow Coma scales of 9 or below or intracranial hemorrhages or involvement of the deep venous system or uncontrollable seizures. So, I mean, these were the indications used. However, it is possible that we need to take into account that a lot of patients do not have favorable outcomes despite the use of best medical treatment. And they do not have these features necessarily. Only there’s like 40 percent of patients who do not return to work after CVT; they’re not dead and they’re so quote unquote “favorable outcomes” but they’re not really favorable because they have all these, you know, list of side effects including persistent headaches, including heavy menstrual bleeding, including problems with getting pregnant, use of anti-seizure medications with all their side effects. And some have persistent seizures. Up to 10% of patients have persistent seizures after the acute event. So you can’t really say that these are favorable outcomes. So it is possible that in future trials, we’ll need to extend the indications to incorporate other patients as well who do not fulfil the criteria that I alluded to before. And for this, we need to develop imaging biomarkers, serum biomarkers, and other clinical features which may identify patients who are best suitable for EVT and have more to gain from the use of EVT.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.