Logo image
Back
Abstract WP11: Use of Endovascular Thrombolysis or Thrombectomy for the Treatment of Cerebral Venous Thrombosis: An Observational Study From the US Nationwide Inpatient Sample
Abstract   Peer reviewed

Abstract WP11: Use of Endovascular Thrombolysis or Thrombectomy for the Treatment of Cerebral Venous Thrombosis: An Observational Study From the US Nationwide Inpatient Sample

Fazeel M Siddiqui, Matthew Weber, Sudeepta Dandapat, Santiago Ortega-Gutierrez, Nazan Aksan, Steve Scaife and Jonathan Coutinho
Stroke (1970), Vol.49(Suppl_1)
01/22/2018
DOI: 10.1161/str.49.suppl_1.WP11

View Online

Abstract

Background: Anticoagulation is considered the first-line treatment for cerebral venous thrombosis (CVT). However, a subset of patients does not respond. Data from case studies suggest endovascular treatment (ET) may be beneficial in such cases. The Nationwide Inpatient Sample (NIS), representing a 20% stratified sample of 7 million annual hospital admissions was used to evaluate the safety and efficacy of ET compared to conservative management in CVT. Methods: We extracted cases from NIS database for years 2004-2013 using ICD 9-CM codes: 437.6, 325, and 671.5. Data related to mechanical thrombectomy (MT) and/or thrombolysis was searched using ICD 9 CPT codes 39.74 and 99.10. Weights were applied to each admission per NIS recommendations to obtain national representation. Groups were matched with respect to age, gender and Charlson index. Data was further adjusted for injury severity score (presence of ICH, stroke, paralysis, midline shift, coma, status epilepticus or need for intubation). Results: Out of 42,889 weighted estimates of CVT cases, 1058 (2%) received ET (616 cases of thrombolysis alone and 442 cases of MT +/- thrombolysis). Patients who received ET were slightly older with higher comorbidity score, and CVT associated complications including ischemic stroke, ICH, coma, status epilepticus, cerebral edema with midline shift and need for endotracheal intubation. Patients who received ET had higher likelihood of having hematological disorders and severe dehydration and lesser likelihood of infection and trauma as underlying etiology of the condition. ET (thrombolysis alone and mechanical thrombectomy +/- thrombolysis) appeared to be significantly associated mortality and bad discharge outcomes in stepwise logistic regression analyses as well as matched paired analyses (Table 1). Conclusion: ET appears to be associated with increased mortality and poor discharge outcomes when compared to conservative treatment in the real-world setting.

Details

Metrics

25 Record Views
Logo image