Abstract Details

Title Direct Oral Anticoagulants Versus Vitamin K Antagonists For Cerebral Venous Sinus Thrombosis: A Systematic Review And Updated Meta-Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - Innovations in Cerebrovascular Therapy (3:42 PM-3:54 PM)

Poster/Presentation
Number 002

Background Cerebral venous sinus thrombosis (CVT) is a rare cause of stroke that lacks high-quality evidence about the most adequate treatment. The preferred pharmacological treatment for CVT remains unclear. Although previous meta-analyses have been conducted on the subject, new data from randomized controlled trials (RCT) has been published.

Objective This study aims to evaluate the efficacy and safety of direct oral anticoagulants (DOACs) in comparison with vitamin K antagonists (VKAs) for this population.

Design/Methods MEDLINE, EMBASE, and COCHRANE databases were systematically searched for randomized trials comparing direct oral anticoagulants with vitamin K antagonists for cerebral venous sinus thrombosis, with no restriction on time of follow-up. Heterogeneity was evaluated using I² statistical parameters. Statistical analysis was performed using the RStudio software, version 4.3.2.

Results Three RCTs, involving a total of 254 patients treated in the post-acute phase of cerebral venous thrombosis (CVT) were included comparing the efficacy of both drugs 129 patients (50,79%) received warfarin and 125 patients (49,22%) received direct oral anticoagulants (DOACs). The results did not show significant differences between warfarin and DOACs in any assessed outcome.For new bleeding events, warfarin did not significantly reduce the risk compared to DOACs (OR 0.40; 95% CI 0.10-1.55; P = 0.090; I² = 58%), indicating moderate heterogeneity among the studies. Regarding recanalization, there was also no significant difference between the treatments (OR 0.71; 95% CI 0.37-1.37; P = 0.570; I² = 0%), with minimal heterogeneity.

Conclusions In this meta-analysis, no significant differences were found between warfarin and DOACs in terms of efficacy and safety for the treatment of CVT. Therefore, no clear treatment superiority can be established with the present data, requiring further RCTs.

Authors/Disclosures
Artur Menegaz de Almeida, MS PRESENTER	Mr. Menegaz de Almeida has nothing to disclose.
Yasmin d. Moura	Miss Moura has nothing to disclose.
Letícia H. Graciolli, Student	Miss Graciolli has nothing to disclose.
Rodrigo S. Pereira, Sr., DO	Mrs. Pereira has nothing to disclose.
Gabriela S. Guerato, Student	Miss Guerato has nothing to disclose.
Sólon B. Nunes	Mr. Nunes has nothing to disclose.
Richard Aldib	Mr. Aldib has nothing to disclose.
Bianca Pimenta de Matos	Ms. Pimenta de Matos has nothing to disclose.
Thallya A. Santos, Medical Student	Miss Santos has nothing to disclose.
Fernanda M. Tamashiro	Miss Tamashiro has nothing to disclose.
Luis Sobreira, MS	Mr. Sobreira has nothing to disclose.

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