Current Endovascular Strategies For Cerebral Venous Thrombosis

Publication Date: June 1, 2018

Recommendations

Imaging

A combination of MRI/MRV or CT/CTV studies should be performed in patients with suspected CVT. (Level C, Class I (benefit > > >risk))
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DSA as a diagnostic modality is indicated in cases of suspected CVT when the diagnosis of CVT cannot be reliably established with non-invasive imaging alone. (Level C, Class IIa (benefit > > risk))
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Medical and surgical treatment

Anticoagulation with unfractionated heparin or low molecular weight heparin is reasonable in patients with CVT. (Level C, Class IIa (benefit > > risk))
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Decompressive craniectomy may be considered in patients with large parenchymal lesions causing herniation or intractable intracranial hypertension. (Level C, Class IIb (benefit > >risk))
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Endovascular therapy

Endovascular therapy may be considered in patients with clinical deterioration despite anticoagulation, or with severe neurological deficits or coma. (Level C, Class IIb (benefit > >risk))
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There is insufficient evidence to determine which endovascular approach and device provides the optimal restoration of venous outflow in CVT. In many cases, a variety of treatment approaches is required to establish sinus patency. (, )
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Recommendation Grading

Disclaimer

Overview

Title

Current Endovascular Strategies For Cerebral Venous Thrombosis

Authoring Organization

Publication Month/Year

June 1, 2018

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The aims of this document include: (1) to review  existing knowledge about the natural history, diagnostic methodology, and treatment modalities/techniques for CVT, and (2) to provide recommendations on management strategies for CVT using the best available evidence, but out of necessity, frequently relying on expert opinion concerning this rare disease. 
 

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Hospital, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D020246 - Venous Thrombosis, D020521 - Stroke

Keywords

stroke, magnetic resonance imaging (MRI), cerebral venous thrombosis (CVT), venography

Source Citation

Lee S, Mokin M, Hetts SW on behalf of the Society of NeuroInterventional Surgery, et al
Current endovascular strategies for cerebral venous thrombosis: report of the SNIS Standards and Guidelines Committee
Journal of NeuroInterventional Surgery 2018;10:803-810.

Methodology

Number of Source Documents
96
Literature Search Start Date
January 1, 1980
Literature Search End Date
December 31, 2016