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Stroke. 2014 Aug;45(8):2469-71. doi: 10.1161/STROKEAHA.114.006167. Epub 2014 Jun 24.

Novel factor xa inhibitor for the treatment of cerebral venous and sinus thrombosis: first experience in 7 patients.

Author information

1
From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany.
2
From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany. simon.nagel@med.uni-heidelberg.de.

Abstract

BACKGROUND AND PURPOSE:

Thrombosis of cerebral veins and sinus (cerebral venous thrombosis) is a rare stroke pathogenesis. Pharmaceutical treatment is restricted to heparin and oral anticoagulation with vitamin K antagonists (VKAs).

METHODS:

Between January 2012 and December 2013, we recorded data from our patients with cerebral venous thrombosis. The modified Rankin scale was used to assess clinical severity; excellent outcome was defined as modified Rankin scale 0 to 1. Recanalization was assessed on follow-up MR angiography. Patients were then divided into 2 treatment groups: phenprocoumon (VKA) and a novel factor Xa inhibitor. Clinical and radiological baseline data, outcome, recanalization status, and complications were retrospectively compared.

RESULTS:

Sixteen patients were included, and 7 were treated with rivaroxaban. Overall outcome was excellent in 93.8%, and all patients showed at least partial recanalization. No statistical significant differences were found between the groups, except the use of heparin before start of oral anticoagulation (P=0.03). One patient in the VKA and 2 patients in the factor Xa inhibitor group had minor bleeding (P=0.55) within the median (range) follow-up of 8 months (5-26).

CONCLUSIONS:

Factor Xa inhibitor showed a similar clinical benefit as VKA in the treatment of cerebral venous thrombosis. Further systematic prospective evaluation is warranted.

KEYWORDS:

cerebral veins; rivaroxaban; thrombosis

PMID:
25070963
DOI:
10.1161/STROKEAHA.114.006167
[Indexed for MEDLINE]

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