Evaluation of recanalization of cerebral venous thrombosis 6 months after treatment and its relationship with the type of anticoagulant treatment

Abstract

Venous thrombosis affecting cerebral veins and sinuses (CVT) is an uncommon neurological condition. Traditionally patients are treated with intravenous heparin followed by an oral vitamin K antagonist like warfarin. Direct oral anticoagulants (DOACs) may offer advantages over warfarin. There is evidence to demonstrate the effectiveness of both dabigatran and rivaroxaban. The aim of this study is to evaluation of recanalization of cerebral venous thrombosis 6 months after treatment and its relationship with the type of anticoagulant treatment. Materials and Methods: This study was a cross-sectional descriptive-analytical study, and the target population included all patients with CVT who referred to Imam Reza Hospital in Tabriz from October 2020 to March 2021 and whose files are available in the relevant department. The sample size was 57 patients, and according to the type of treatment and exclusion criteria, 45 patients were finally included in the study. The sampling method in this study was a census. First, demographic information about the patients, such as age, gender, and presence of underlying diseases, was extracted from the patient records and recorded in the relevant checklist. Next, the patients' brain MRI and MRV images were examined and interpreted and the relevant data were recorded. Information about the patient's condition by MRI 6 months after the start of treatment was also extracted from the centers and interpreted where the treatment was performed, and the lesion size and recanalization rate were examined based on control images and compared between the two study groups. In this study, the recanalization rate was divided into three groups based on imaging: complete, partial, and no recanalization. On the other hand, the relationship between the recanalization rate and the type of treatment received (treatment with warfarin and treatment with new anticoagulant drugs such as apixaban) was also examined and compared. Results: In this study, among the location and extent of venous sinus thrombosis, none of the variables SSS, Transverse sinus, Sigmoid sinus, Jugular, Deep Veins and Cortical Veins were found to have a statistically significant relationship between the two groups of patients treated with new anticoagulants and warfarin (P>0.05). Also, in this study, there was no statistically significant difference between the location and extent of venous sinus thrombosis before and after 6 months of treatment with new anticoagulants and warfarin in the studied individuals (P>0.05). There was no statistically significant relationship between the rate of recanalization between the two groups of patients treated with new anticoagulants and warfarin (P>0.05).