Intravascular Interventional Therapy For Severe Intracranial Venous Sinus Thrombosis Clinical Prognosis Related Factors

Objective:The clinical data and prognostic evaluation results of patients undergoing endovascular sinus thrombosis(CVST,Cerebral venous sinus thrombosis)were analyzed to obtain the relevant factors affecting the prognosis of the treatment,and the patients with severe cerebral venous sinus thrombosis Treatment and prognosis provide a basis for clinical research.Methods: Patients with severe intracranial venous sinus thrombosis who underwent endovascular intervention in Hunan Provincial People's Hospital from january 2013 to december 2018 were selected as subjects.Clinical data(including medical history and physical examination,blood examination,Lumbar puncture examination,imaging examination and complications examination)and follow-up results were collected.The data of sex,age,etiology,onset form,clinical symptoms and signs,location of thrombosis,time of venous filling under DSA(determined by imaging data),treatment methods,and discharge status were retrospectively collected.According to the modified Rankin cale(mRS)score,the patients were divided into a good prognosis group(mRS score ? 2 points)and a poor prognosis group(mRS score > 2 points).Univariate analysis used ?2 test or Fisher's exact probability method,and multivariate logistic regression analysis to determine independent factors that influence prognosis.Results: The total of 46 patients,26 males and 20 females,with an average age of(37.78 ±10.89)years,were enrolled in this study.There were 12 cases of complete recovery and 34 cases of incomplete recovery.There were 26 patients with good prognosis and 20 patients with poor prognosis after interventional therapy.Univariate analysis showed that gender(female),focal neurological dysfunction,hemorrhage,multiple comorbidities,unclear etiology,and DSA lower venous filling time ?10 seconds were the risk factors of poor prognosis of endovascular interventional therapy for severe CVST.Multivariate logistic regression analysis showed that gender(female)(OR =6.043,95% CI=5.283-7.069,P=0.018),hemorrhage(OR=5.128,95%CI= 4.337-5.876,P=0.001),focal neurological dysfunction(OR=5.563,95%CI= 4.254-6.863,P=0.001),unclear etiological factors(OR=0.179,95%CI= 0.165-0.211,P= 0.013),and time of venous filling under DSA?10s(OR=3.541,95%CI=2.925-3.784,P=0.020)were independent risk factors for poor prognosis after intravascular interventional therapy,while multiple comorbidities(OR = 2.296,95% CI = 0.828-6.312,P =0.058)were not Independent risk factors.Conclusions:Intravascular intervention for patients with severe CVST can achieve a better prognosis.Gender(female),focal neurological dysfunction,cerebral hemorrhage,multiple comorbidities,unclear etiology,venous filling time under DSA ?10s are influential factors for poor prognosis of severe CVST,while gender(female),focal neurological dysfunction,cerebral hemorrhage,unclear cause,and intravenous filling time under DSA were independent risk factors.