Endovascular Thrombectomy for Cerebral Venous Thrombosis: Current Status and Future Directions

Abstract

Cerebral venous thrombosis (CVT) represents a relatively rare cause of stroke, yet it carries an overall rate of death or dependency of up to 15%. The mainstay of its management is therapeutic anticoagulation, either subcutaneously or intravenously in the acute phase, followed by oral anticoagulation therapy to recanalize the occluded sinus or vein and prevent thrombus expansion and recurrence. The use of endovascular therapy (EVT) for CVT is controversial. Endovascular administration of thrombolysis or mechanical thrombus aspiration, or a combination of both, has yielded variable results in case reports and uncontrolled studies. Little is known about which pre- or postprocedural clinical and neuroimaging features predict improved outcomes after EVT for CVT. In this review, we describe EVT risks and potential benefits, discuss clinical and imaging features associated with prognosis and EVT effect, and outline the evidence behind EVT for CVT using illustrative case examples.