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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB1453 - Clinical course and long-term outcomes of cerebral venous sinus thrombosis in Asians

    Tuesday, June 27, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: Incidence and long-term outcomes of cerebral venous sinus thrombosis (CVST) in the Asian population are still scarce.

    Aims: This study aimed to investigate the incidence of CVST in the Thai population, as well as the contributing factors, clinical presentation, and long-term outcomes.

    Methods: This was a single-center, retrospective study at a university-based-referral hospital in Thailand. Consecutive patients who were diagnosed with CVST between January 2010 and December 2020 were included.

    Results: There were 107 CVST patients with a median age of 43.7 ± 20.4 years. The estimated incidence of CVST in Thai population was 0.66 per 100,000 patients-year. Neurological outcomes were significantly improved after the treatment, as demonstrated by the proportions of patients with mRs 0-1 increasing from 18.6% at diagnosis to 83.2% and 85.1% at 3 and 6 months, respectively (P=0.026, P=0.038) (Figure 1). There were 54 (50.5%) patients in non-extended treatment group (median treatment time 15.95 months) and 53 (49.5%) patients in extended treatment group (median treatment time 41.64 months). Recurrent CVST was 3.7%. Anticoagulant discontinuation was not associated with an increased risk of recurrent CVST (HR 0.71, 95% CI 0.10-5.10, P=0.74). Major and overall bleeding were observed in 6.5% and 13.1% of the cases, respectively. In acute treatment, LMWH had a numerically lower risk of bleeding as compared to heparin (HR 0.62, 95% CI 0.16-2.40; P = 0.49). In long-term treatment, LMWH and DOAC did not significantly reduce the risk of bleeding compared to warfarin, with HR 0.39 (95%CI 0.13-1.18, P=0.10) and HR 0.63 (95% CI 0.08-5.18, P=0.67). Overall mortality was 2.3%. Of which 50% were related to major bleeding.

    Conclusion(s): Patients with CVST had high bleeding complication and overall mortality. Most patients showed significant improvement of neurological outcomes as measured by mRS. Anticoagulant could be discontinued safely in selected patients, especially those who had provoked CVST by hormonal therapy.