ESOC 2022 | Cerebral venous thrombosis: updates on epidemiology & management

Cerebral venous thrombosis (CVT) is a distinct cerebrovascular disorder more commonly affecting young adults, especially women of fertile age. Diana Aguiar de Sousa, MD, PhD, Lisbon Central University Hospital Center, University of Lisbon, Lisbon, Portugal, summarizes recent advances on the knowledge of patients with CVT. Recent cohort studies suggest that the incidence of CVT is higher than previously estimated, with an overall prevalence of 16 cases per million per year. New risk factors have also been identified, including anemia, obesity, and vaccine-induced immune thrombotic thrombocytopenia. Therapeutic anticoagulation is the standard treatment in CVT and recent studies have investigated direct oral anticoagulant use, showing low risk of recurrent venous thrombotic events and low bleeding risk. Research into the extent and timing of venous recanalization is ongoing. Endovascular treatment (EVT) is also under investigation in this setting, with the neutral results of the first randomized trial assessing adjunctive EVT with standard anticoagulation published in 2020 (TO-ACT; NCT01204333). Prof. Aguiar de Sousa comments on the importance of improving patient selection for EVT to improve outcomes. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.