Dural arteriovenous fistulae after cerebral venous thrombosis
Background and Purpose:This analysis examined the frequency of dural arteriovenous fistulae (dAVF) after cerebral venous thrombosis (CVT) in patients included in a randomized controlled trial comparing dabigatran etexilate with dose-adjusted warfarin (RE-SPECT CVT [A Clinical Trial Comparing Efficac...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
25 Sep 2020
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| In: |
Stroke
Year: 2020, Volume: 51, Issue: 11, Pages: 3344-3347 |
| ISSN: | 1524-4628 |
| DOI: | 10.1161/STROKEAHA.120.031235 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1161/STROKEAHA.120.031235 Verlag, lizenzpflichtig, Volltext: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.031235 
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| Author Notes: | Ferro José M., Coutinho Jonathan M., Jansen Olav, Bendszus Martin, Dentali Francesco, Kobayashi Adam, van der Veen Bas, Miede Corinna, Caria Jorge, Huisman Holger, Diener Hans-Christoph, and on behalf of the RE-SPECT CVT Study Group |
| Summary: | Background and Purpose:This analysis examined the frequency of dural arteriovenous fistulae (dAVF) after cerebral venous thrombosis (CVT) in patients included in a randomized controlled trial comparing dabigatran etexilate with dose-adjusted warfarin (RE-SPECT CVT [A Clinical Trial Comparing Efficacy and Safety of Dabigatran Etexilate With Warfarin in Patients With Cerebral Venous and Dural Sinus Thrombosis]), who had systematic follow-up magnetic resonance (MR) imaging.Methods:RE-SPECT CVT was a Phase 3, prospective, randomized, parallel-group, open-label, multicenter, exploratory trial with blinded end point adjudication. We allocated patients with acute CVT to dabigatran 150 mg twice daily or dose-adjusted warfarin, for 24 weeks and obtained a standardized MR protocol including time-of-flight MR angiography, 3-dimensional phase-contrast venography, and 3-dimensional contrast-enhanced MR venography at the end of the treatment period. A blinded adjudication committee assessed the presence of dAVF in a predefined substudy of the trial.Results:We analyzed development of dAVF in 112 of 120 randomized patients; 57 allocated to dabigatran and 55 to warfarin. For 3 (2.7%) of these 112 patients, quality of follow-up imaging was insufficient to evaluate dAVF. A dAVF (Borden I) was found in 1 patient (0.9%) allocated to warfarin; however, this dAVF was already present at baseline. The patient did not present with hemorrhage at baseline or during the trial and was asymptomatic at follow-up.Conclusions:Despite systematic imaging, we found no new dAVF 6 months after CVT. Routine follow-up cerebral MR angiography aiming to detect new dAVF 6 months after CVT has a very low yield.Registration:URL: https://www.clinicaltrials.gov. Unique identifier: NCT02913326. |
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| Item Description: | Gesehen am 30.11.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1524-4628 |
| DOI: | 10.1161/STROKEAHA.120.031235 |