Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial
Background: Prospective multicenter data on the treatment and outcomes of children with cerebral sinovenous thrombosis (CSVT) are limited. We aimed to describe the clinical characteristics, treatment strategies, and outcomes of patients with a first-episode of provoked acute CSVT enrolled in the Kid...
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Elsevier
2024-10-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2475037924003005 |
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| author | Gary M. Woods Alexandra Miller Maua Mosha Christoph Male Anupam Verma Nicole Kucine Christine Sabapathy Kisha Beg Sanjay Ahuja Deepti Raybagkar Kerry Hege Clara Lo Rukhmi Bhat Thomas Abshire Neil A. Goldenberg |
| author_facet | Gary M. Woods Alexandra Miller Maua Mosha Christoph Male Anupam Verma Nicole Kucine Christine Sabapathy Kisha Beg Sanjay Ahuja Deepti Raybagkar Kerry Hege Clara Lo Rukhmi Bhat Thomas Abshire Neil A. Goldenberg |
| author_sort | Gary M. Woods |
| collection | DOAJ |
| description | Background: Prospective multicenter data on the treatment and outcomes of children with cerebral sinovenous thrombosis (CSVT) are limited. We aimed to describe the clinical characteristics, treatment strategies, and outcomes of patients with a first-episode of provoked acute CSVT enrolled in the Kids-DOTT trial and compare these features with those of participants with non-CSVT venous thromboembolism (VTE). Methods: This was a subgroup analysis from the Kids-DOTT trial, a multinational randomized clinical trial on duration of anticoagulation for provoked acute VTE in patients younger than 21 years. Patient and thrombus characteristics, treatments, and outcomes of patients diagnosed with CSVT were compared with those of patients with non-CSVT VTE. Results: CSVT was diagnosed in 75 of the 532 (14%), 25 of whom received 6 weeks of anticoagulant treatment and 50 received 3 or more months. When compared with non-CSVT VTE, CSVT was more likely to occur in neonates and young children, associated with infection in general and acute head/neck infection in particular, and less likely to be related to central venous catheter. No patient in either group developed symptomatic recurrent VTE or clinically relevant bleeding, and there was no significant difference in rates of complete thrombus resolution between the 2 treatment durations. Conclusion: CSVT is most common in neonates and young children and those with acute head and neck infections. A 6-week anticoagulation treatment course appears to be safe (no clinically relevant bleeding) and effective (no difference in symptomatic recurrent VTE) for provoked acute pediatric CSVT. Nevertheless, given the nature of a subpopulation analysis, these findings should be interpreted with caution. |
| format | Article |
| id | doaj-art-ab23ac54130a4c6e904f9eb9942c41c7 |
| institution | Kabale University |
| issn | 2475-0379 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj-art-ab23ac54130a4c6e904f9eb9942c41c72024-11-23T06:31:28ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792024-10-0187102605Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational TrialGary M. Woods0Alexandra Miller1Maua Mosha2Christoph Male3Anupam Verma4Nicole Kucine5Christine Sabapathy6Kisha Beg7Sanjay Ahuja8Deepti Raybagkar9Kerry Hege10Clara Lo11Rukhmi Bhat12Thomas Abshire13Neil A. Goldenberg14Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA; Correspondence Gary Woods, Children’s Healthcare of Atlanta and Emory University School of Medicine, 2220 N Druid Hills Rd NE, Atlanta, GA 30329, USA.Data Coordinating Center for Pediatric Multicenter Studies, Johns Hopkins All Children’s Hospital Institute for Clinical and Translational Research, St. Petersburg, Florida, USAData Coordinating Center for Pediatric Multicenter Studies, Johns Hopkins All Children’s Hospital Institute for Clinical and Translational Research, St. Petersburg, Florida, USADepartment of Pediatrics, Medical University of Vienna, Vienna, AustriaDepartment of Pediatrics, University of Utah and Primary Children’s Hospital, Salt Lake City, Utah, USADepartment of Pediatrics, Weill Cornell Medical College and Presbyterian/Weill Cornell, New York, New York, USADepartment of Pediatrics, McGill University Health Centre and The Montreal Children’s Hospital, Montreal, Québec, CanadaDepartment of Pediatrics, University of Oklahoma College of Medicine and The Children’s Hospital at OU, Oklahoma City, Oklahoma, USADepartment of Pediatrics, Case Western Reserve University School of Medicine and Rainbow Babies & Children’s Hospitals, Cleveland, Ohio, USADepartment of Pediatrics, Drexel University College of Medicine and St. Christopher’s Hospital for Children, Philadelphia, Pennsylvania, USADepartment of Pediatrics, Indiana University School of Medicine and Riley Children’s Health, Indianapolis, Indiana, USADepartment of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California, USADepartment of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois, USADepartment of Pediatrics and Medicine, Medical College of Wisconsin and Versiti Blood Research Institute, Milwaukee, Wisconsin, USADepartment of Pediatrics and Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USABackground: Prospective multicenter data on the treatment and outcomes of children with cerebral sinovenous thrombosis (CSVT) are limited. We aimed to describe the clinical characteristics, treatment strategies, and outcomes of patients with a first-episode of provoked acute CSVT enrolled in the Kids-DOTT trial and compare these features with those of participants with non-CSVT venous thromboembolism (VTE). Methods: This was a subgroup analysis from the Kids-DOTT trial, a multinational randomized clinical trial on duration of anticoagulation for provoked acute VTE in patients younger than 21 years. Patient and thrombus characteristics, treatments, and outcomes of patients diagnosed with CSVT were compared with those of patients with non-CSVT VTE. Results: CSVT was diagnosed in 75 of the 532 (14%), 25 of whom received 6 weeks of anticoagulant treatment and 50 received 3 or more months. When compared with non-CSVT VTE, CSVT was more likely to occur in neonates and young children, associated with infection in general and acute head/neck infection in particular, and less likely to be related to central venous catheter. No patient in either group developed symptomatic recurrent VTE or clinically relevant bleeding, and there was no significant difference in rates of complete thrombus resolution between the 2 treatment durations. Conclusion: CSVT is most common in neonates and young children and those with acute head and neck infections. A 6-week anticoagulation treatment course appears to be safe (no clinically relevant bleeding) and effective (no difference in symptomatic recurrent VTE) for provoked acute pediatric CSVT. Nevertheless, given the nature of a subpopulation analysis, these findings should be interpreted with caution.http://www.sciencedirect.com/science/article/pii/S2475037924003005intracranialpediatricssinus thrombosisthrombosisvenous thromboembolism |
| spellingShingle | Gary M. Woods Alexandra Miller Maua Mosha Christoph Male Anupam Verma Nicole Kucine Christine Sabapathy Kisha Beg Sanjay Ahuja Deepti Raybagkar Kerry Hege Clara Lo Rukhmi Bhat Thomas Abshire Neil A. Goldenberg Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial Research and Practice in Thrombosis and Haemostasis intracranial pediatrics sinus thrombosis thrombosis venous thromboembolism |
| title | Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial |
| title_full | Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial |
| title_fullStr | Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial |
| title_full_unstemmed | Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial |
| title_short | Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial |
| title_sort | clinical characteristics treatment and outcomes of provoked acute cerebral sinovenous thrombosis in patients 21 years old findings from the kids dott multinational trial |
| topic | intracranial pediatrics sinus thrombosis thrombosis venous thromboembolism |
| url | http://www.sciencedirect.com/science/article/pii/S2475037924003005 |
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