Endovascular Treatment for Cerebral Venous Thrombosis: Applying Lessons Learned from Clinical Trials of Endovascular Treatment in Acute Arterial Ischemic Stroke

Background:Cerebral venous thrombosis (CVT) is a rare butseverely disabling form of stroke. Acute treatment mainlyconsists of medical management, since there is no robustevidence suggesting the benefit of endovascular treatmentfor CVT. Given the relative lack of data to guide acutetreatment decision-making, CVT treatment decisions aremostly made on a case-by-case basis. In some ways, thecurrent status quo of endovascular treatment for CVT re-sembles the state of endovascular treatment for acute is-chemic stroke before the wave of major positive large vesselocclusion endovascular treatment trials in 2015.Summary:The current state of evidence with regard to endovascularCVT treatment is summarized, parallels to acute ischemicstroke are drawn, and it is discussed how the lessons learnedfrom the evolution of acute ischemic stroke endovasculartreatment (EVT) trials could be applied to designing a trial ofendovascular treatment for CVT. The review ends by out-lining possible scenarios for the future of endovascular CVTtreatment.KeyMessages:CVT is a serious disease, affectingyoung patients and their families, and harbors a consider-able social and economic burden. Working toward high-level evidence for the best possible treatment strategy andexploring a possible role for EVT to improve outcomes in CVTneeds to remain a high priority in stroke research.(c) 2024 S. Karger AG, Basel