Thrombosis and bleeding outcomes in the treatment of cerebral venous thrombosis in cancer

Background There is a need for clinical outcome data of cerebral venous thrombosis (CVT) in cancer patients. We examined the recanalization, thrombosis recurrence and major bleeding during CVT treatment in a cancer exclusive adult population. Methods We performed a retrospective review of cancer associated CVT identified through an institutional data warehouse. The primary endpoint was radiological and comprised the evaluation of thrombus recanalization at 12 months. Secondary endpoints were clinical and included rates of bleeding complications and recurrence of CVT. Variables were compared across subgroups of study outcomes. The backward stepdown procedure was used to identify variables for the final logistic model regarding thrombosis and bleeding outcomes. Results The population included forty-five patients, slightly predominant of male adults (55.6%) with a median age of 54.5 years. Solid malignancies comprised 64.4% of cases. A total of 31 cases were treated with anticoagulation. CVT recanalization was documented in almost 60% of cases. The cerebral venous thrombosis recurrence or propagation rate at 12 months was 15.6%. Major bleeding complications were observed in 15 patients. Conclusions Our findings are suggestive of a narrow therapeutic index of anticoagulation in cancer-CVT. Careful monitoring of anticoagulation effect and bleeding complications are of utmost clinical relevance in cancer patients. Further larger and controlled studies are needed to confirm our observations.

Automated summary

This study retrospectively reviewed the treatment of cerebral venous thrombosis in 45 cancer patients, finding recanalization in nearly 60% of cases, a recurrence or propagation rate of 15.6% at 12 months, and major bleeding complications in 15 patients. The findings suggest a narrow therapeutic index of anticoagulation in cancer patients with CVT, highlighting the importance of careful monitoring for anticoagulation effect and bleeding complications. Further larger and controlled studies are needed to validate these observations.