Abstract TMP82: Comparison Of Direct Oral Anticoagulants To Vitamin K Antagonists For Treatment Of Cerebral Venous Sinus Thrombosis

Abstract

Introduction: Direct oral anticoagulants (DOACs) have gained popularity in treating cerebral venous thrombosis (CVT). However, studies comparing the use of DOACs to Vitamin K antagonists (VKA) among patients with CVT are limited. Methods: We conducted a single-center retrospective cohort study comparing VKA to DOAC-treated CVT patients. Clinical, radiographic findings and outcomes were compared. Continuous and categorical variables were compared using t-test or Wilcoxon test and Chi-square or Fisher's exact test, as appropriate. Results: 82 CVT patients were included in final analysis (mean age 41.3±16.3, 76.8% women). Thirty (37%) were treated with DOACs. There was no difference in clinical or radiographic characteristics between the two groups. There was no death and majority of patents were discharged home (p=0.11). Sixty-one patients (74.4%) had follow-up imaging within a year. Fifteen, thirty-seven and nine patients had complete, partial, and no vessel recanalization, respectively. There was no difference in recanalization status between the DOAC and VKA groups (p=0.53). 68 patients (82.3%) had follow-up data on headache status: 21(31%) reported resolution and 45(66%) partial improvement with no difference between DOAC and VKA groups (p=0.81). One patient in the DOAC group had a recurrent CVT. One patient in the VKA group had a major hemorrhage within 3 months. Conclusion: We found no significant difference in venous recanalization or outcomes in patients with CVT treated with DOAC vs VKA. DOAC appears to be a safe alternative to VKA. Large multicenter studies are needed to better evaluate the efficacy and safety of DOAC in CVT.