Logo image
Back
Abstract DP280: Recurrence After a First Cerebral Venous Thrombosis: Pooled Risks of Recurrent CVT, Other VTE, and Mortality - Systematic Review and Meta-analysis
Abstract   Peer reviewed

Abstract DP280: Recurrence After a First Cerebral Venous Thrombosis: Pooled Risks of Recurrent CVT, Other VTE, and Mortality - Systematic Review and Meta-analysis

Nashwa Abdelhakim, Anderson Brito Alvarado, Eric Kontowicz, Milagros Galecio-Castillo, Leonardo Cruz-Criollo, Jorge Cespedes Segura and Santiago Ortega-Gutierrez
Stroke (1970), Vol.57(Suppl_1), DP280
02/2026
DOI: 10.1161/str.57.suppl_1.DP280

View Online

Abstract

Introduction: Cerebral venous thrombosis (CVT) generally has favorable outcomes, yet the risk of recurrence and other venous thrombotic events (VTE) remains a critical concern for long-term management. Accurate pooled estimates are essential to guide secondary prevention strategies and the duration of anticoagulation. Objective: To quantify pooled risks of recurrent CVT, other VTE, and all-cause mortality after a first CVT and to compare outcomes by anticoagulant class. Methods: We conducted a systematic search was performed from inception to March 2025. Eligible studies reported post-index CVT recurrence and/or VTE and mortality. Outcomes were pooled using random-effects meta-analysis. Prespecified subgroups included anticoagulation status, subtypes, and CVT recanalization at follow-up. Results: Fifty-four studies (N=9,985 patients after first CVT) met inclusion criteria. The pooled CVT recurrence rate was 2.87% (P<0.0001; I2= 92.3%), and the pooled VTE rate was 3.84% (P <0.0001, I2 = 83.1%). All-cause mortality was 5.45% (p<0.0001, I2 = 91.5%). In studies reporting anticoagulation intake, pooled recurrence had CVT and VTE recurrence rates of 3.87% (p<0.0001, I2 = 97.5%). DOACs were associated with fewer VTE recurrences in comparison to vitamin K antagonists (VKA), (RR,0.82 [95% CI, 0.69-0.99], p = 0.9, I2 = 0%), and CVT recanalization did not differ,(OR, 0.91 [95% CI, 0.57-1.44], p = 0.09, I2 = 54.3%). Conclusion: After a first CVT, recurrent CVT and subsequent VTE are infrequent but clinically meaningful. Anticoagulation, particularly DOACs, appears to reduce recurrence with recanalization comparable to VKAs. These findings support DOACs as a reasonable alternative for secondary prevention, while high-quality randomized trials are needed to define optimal long-term strategies and patient selection.
 Prevention Effectiveness Anticoagulation Cerebral venous thrombosis

Details

Metrics

1 Record Views
Logo image