Nationwide Study on Clinical Outcomes of Endovascular Interventions for Cerebral Venous Thrombosis in Japan

BackgroundCerebral venous thrombosis (CVT) is a rare but devastating disease, with some patients experiencing disease deterioration despite treatment. Endovascular treatment is an anticipated option, but its clinical relevance is yet to be determined. This observational study aimed to assess the clinical effects and identify patient populations that may benefit from treatment. MethodsPatient data from April 2014 to March 2022 were extracted from a nationwide Japanese database. The primary outcome was in-hospital mortality, while secondary outcomes included modified Rankin Score ([≥] 3) and posthospitalization complications. Severity adjustments were performed using a generalized linear mixed model and propensity score matching. ResultsThe analysis included 2901 patients; 240 patients in the endovascular treatment group were matched with 240 patients in the standard treatment group. After adjusting for background factors, endovascular treatment did not improve in-hospital mortality (adjusted odds ratio 1.45 [95% CI: 0.74-2.16]) or the modified Rankin Score (adjusted odds ratio 0.89 [95% CI: 0.56-1.23]). No subpopulations that could benefit from endovascular treatment were identified. However, posthospitalization intracranial complications did not increase with endovascular treatment (0.8% vs. 1.2% in the standard treatment group). ConclusionsEndovascular treatment did not show any clinical benefit in patients with CVT. These findings are crucial for guiding clinical decisions and suggest that further evidence is warranted.