Abstract 2: Timing And Predictors Of Recanalization After Cerebral Venous Thrombosis

Abstract

Background and Purpose: Recanalization after cerebral venous thrombosis (CVT) is poorly understood. We aimed to investigate predictors and timing of recanalization in a large, international cohort of patients with CVT. Materials and Methods: We used data from the multicenter, international, AntiCoagulaTION in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with confirmed CVT from 01/2015 to 12/2020. Our analysis included patients that had undergone repeat venous neuroimaging more than 30 days after initiation of anticoagulation treatment. Pre-specified variables were included in univariate and multivariable analyses to identify independent predictors of failure to recanalize. We also examined improvement in recanalization at clinically-relevant time points ( <75 days, 3 months ± 15 days, 6 months ± 30 days, and 12 month ± 30 days) after the initial CVT hospital admission. Results: Among the 551 patients (mean age, 44.4 ± 16.2 years, 66% women) that met inclusion criteria, 486 (88.2%) had complete or partial, and 65 (11.8%) had no recanalization. In multivariable analysis, older age (OR, 1.05; 95% CI, 1.03 - 1.07), male sex (OR, 0.44; 95% CI, 0.24 - 0.80), and lack of parenchymal changes on baseline imaging (OR, 0.53; 95% CI, 0.29 - 0.96) were associated with no recanalization. The majority of improvement in recanalization (71.1%) occurred before 3 months from initial diagnosis. A high percentage of complete recanalization (59.0%) took place within the first 3 months after diagnosis. Discussion: Older age, male sex, and lack of parenchymal changes were associated with no recanalization after CVT. The majority of improvement in recanalization and complete recanalization occurred early in the disease course.