JAMA Neurol: Effects of vascular therapy on functional prognosis in patients with severe cerebral venous thrombosis

Recently, researchers evaluated the effectiveness and safety of intravascular therapy (EVT) for patients with severe cerebral venous thrombosis (CVT)TO-ACT study was conducted in eight hospitals in three countries (Netherlands, China, and Portugal) involving patients with radiology-diagnosed CVT who had at least one adverse prognosis risk factor, such as mental disorder, coma, cerebral hemorrhage, or deep vein thrombosis, and was randomly accepted evT (intervention group) or control (control group) on the basis of standard treatment in the guidelinesEVT treatment includes mechanical thrombosis, local sinus application of atepase or urinary kinase, or a combination of two methodsThe intervention group followed the EVT as soon as possible within 24 hours of the random groupingThe main endpoint of the study was the proportion of patients with a good prognosis at 12 months of age (no disability recovery; improved Rankin scale (mRS) score of 0-1)The secondary endpoint was the patient ratio with a mRS score of 0-1 at 6 months, the ratio of 0-2 patients with mRS score at 6 months and 12 months, the mRS result at 12 months, the re-pass rate, and CVT-related surgical interventionof 67 patients, 33 (49%) received EVT interventions and 34 (51%) were controlledThe intervention group was slightly older (43 vs 38 years) and fewer women (70 percent vs 79 percent) than the control groupThe National Institutes of Health's median stroke score was 12 in the EVT group and 12 in the standard care groupIn a 12-month follow-up, 22 intervention patients (67%) had an mRS score of 0-1, while 23 control patients (68%) had an mRS score of 0-1 (a relative risk ratio of 0.998)There was no statistically significant increase in mortality in the EVT group (12% (n?4) vs 3% (n?1) The incidence of asymptomatic cerebral hemorrhage in the intervention group was not statistically significant (3% (n?1) vs 9% (n?3)TO-ACT trials showed that intravascular therapy had no significant improvement in the functional prognosis of patients with severe cerebral venous thrombosis