Abstract Details

Title Comparative Analysis of the Treatment Options for Cerebral Venous Sinus Thrombosis in the United States

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 235

Objective

Background BACKGROUND: Cerebral Venous Sinus Thrombosis is most commonly treated with anticoagulation. Thrombolysis and Mechanical thrombectomy are novel approaches in the treatment of CVST.

Design/Methods DESIGN/METHODS: CVST patients were identified and data were collected from the Nationwide Inpatient Sample database for years 2008-2009 using billing codes. Statistical analysis was done using Chi-square tests, Analysis of variance (ANOVA) and Kruskal-Wallis tests.

Results RESULTS: A total of 1172 patients were included in the analyses. 115 (9.8%) were treated with anticoagulation, 17 (1.5%) with thrombolytics and 9 (0.8%) with endovascular methods. Patients who underwent treatment were more likely to have hematological conditions (24% vs. 16%, P= 0.018) and CNS infection (6% vs. 1%, p=0.022). In treatment vs. no treatment group, there was no difference in unadjusted inpatient mortality (4% vs. 4%), discharge to home (67% vs. 64%), median length of stay in days (6 vs. 6, p= 0.429) and hospital charges in USD (30,794 vs. 35,707, p= 0.078). Compared to anticoagulation subgroup, thrombolytic and endovascular subgroups had more thrombotic events (12% vs. 35% & 67%, p=<0.001), ischemic strokes (8% vs. 24% & 44%, p=0.002), hemorrhagic strokes (9% vs. 24% &11%, p=0.032), inpatient mortality (0% vs. 24% & 11%, p=<0.001), median LOS (5 vs. 8 & 13 days, p=<0.001) and hospital charges (USD 26,335 vs. 87,807 & 206,824, p=0.001).

Conclusions CONCLUSIONS: Although anticoagulation is the standard of care for CVST, it seems that it is either under utilized or under reported. Anticoagulation remains the most common, least expensive and safest method of treatment based on our cohort.

Authors/Disclosures
Keyur Patel, MD PRESENTER	No disclosure on file
Chandan B. Mehta, MD (Henry Ford Hospital)	Dr. Mehta has nothing to disclose.
Nelson J. Maldonado, MD (Neuro Quito)	No disclosure on file
Omran Kaskar, MD (Neuro Team One)	No disclosure on file
Lonni Schultz, PhD (Henry Ford Hospital)	Dr. Schultz has nothing to disclose.
Tamer Abdelhak, MD (Albany Medical College)	Dr. Abdelhak has nothing to disclose.
Panayiotis N. Varelas, MD, PhD, FAAN (Albany Med-Department of Neurology)	Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astra Zeneca -Alexion - Portola. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Annexon. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca- Alexion-Portola. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Annexon. Dr. Varelas has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Giammarco, Mullins & Horton P.C. The institution of Dr. Varelas has received research support from Marinus. The institution of Dr. Varelas has received research support from Bayer. Dr. Varelas has received publishing royalties from a publication relating to health care. An immediate family member of Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Rep to the RUC meeting with AAN. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving as a Speaker at the Annual Meeting with AAN. Dr. Varelas has a non-compensated relationship as a President - Past President with Neurocritical Care Society that is relevant to AAN interests or activities.
Gioacchino Tedeschi, MD (University of Campania "L. Vanvitelli")	Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis.

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