Abstract Body: Title: Endovascular Treatment for Cerebral Venous Thrombosis Among Children in China from 2018 to 2022
Background:
Endovascular treatment is increasingly being used to manage severe cerebral venous thrombosis (CVT) in adults, despite limited evidence supporting its safety and efficacy. However, research on endovascular treatment for CVT in children remains scarce, with virtually no studies available on the subject. In this paper, we present findings from a comprehensive national study that sheds light on the current landscape of CVT in children in China and endovascular treatment in this population in a real-world setting.
Methods:
This study is a retrospective analysis assessing the endovascular treatment of pediatric patients with cerebral venous sinus thrombosis from January 2018 to June 2022 (NCT05448248). Mixed effects logistic regression was employed to assess the association of endovascular treatment on outcomes for cerebral venous sinus thrombosis, accounting for variations between hospitals.
Results:
A total of 152 children were included in the follow-up and subsequent analysis, with 25 (16.5%) receiving endovascular treatment and 127 (83.5%) receiving standard care. The mean age of the participants was 13.6 years (SD = 3.98), with 35.5% being female. Endovascular treatment included mechanical thrombectomy alone (76.0%), intrasinus thrombolysis (12.0%), combination of mechanical thrombectomy and intrasinus thrombolysis (8.0%), or intrasinus stenting (4.0%). Compared to the standard care group, patients who received endovascular treatment showed no significant difference in the likelihood of good functional recovery (modified Rankin Scale 0-1) at present (odds ratio 0.43, 95% CI 0.09 to 2.12) or at discharge (odds ratio 0.46, 95% CI 0.15 to 1.43) .
Discussion
To our knowledge, this is the first study with a control group to evaluate the association of endovascular treatment with outcomes in children. This study demonstrated that endovascular treatment did not improve functional recovery compared to standard care, consistent with the only randomized controlled trial in adults.
The limitations of this study include its retrospective design, observational nature, and small sample size. Our findings suggest that endovascular treatment for cerebral venous thrombosis in children should be approached with caution, given the absence of quality evidence.