Table 1.
Summary of the 21 records included in this systematic review.
| Reference | Treatment | Outcome Assessment | Localization | Complications | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Author (Year) | Study Type | Period | n (N) | Inclusion Criteria/Treatment Allocation | Pre-ICH | Endovascular Treatment | Control Group | FU (Month) | Outcome | Death | Recanal. | SSS | SS | Sig S | TS | DV | Catheter * | ICH ** | Other |
| Coutinho et al. (2020) [38] | RCT | 2011–2016 | 33 (67) | High probability of poor outcome, at least 1 of the following risk factors: mental status disorder, coma state (GCS <9), ICH, or thrombosis of the deep cerebral venous system (exclusion: duration from diagnosis of more than 10 days, pregnancy (women in the puerperium were eligible); thrombocytopenia (platelet count, <100 × 109/L), clinical and radiological signs of impending transtentorial herniation) | n = 22 | n = 33; LT (alteplase, urokinase; up to 72 h): n = 17 (52%); MT: n = 30 (91%) (AngioJet [n = 14], SR [n = 5], B [n = 3], aspiration (A) [n = 3; Penumbra], microcatheter [n = 3], other [n = 9]) | n = 34; standard care | 6, 12 | mRS 0–1 (12 months): n = 22 (67%) vs. n = 23 (68%); risk ratio 0.99 (95% CI 0.71–1.18) |
12 months; n = 4 (12%) [vs. n = 1 (3%)] |
SSS (6–12 months): 79% vs. 52%, 1.52 (1.02–2.27); SS (6 months): 96% vs. 86%, 1.13 (0.95–1.33) |
n = 23 (70%) | n = 17 (52%) | l: n = 12 r: n = 15 | l: n = 16 r: n = 22 | n = 14 (42%) | n = 3 (9%) |
n = 6 (18%) (hem. compl.) |
NA |
| Nyberg et al. (2017) [39] | retrosp | 2011–2015 | 29 (66) | SVT (anticoagulation), decision of treatment team | n = 17 (n = 10 in CC) | LT n = 29 (24–72 h); n = 21 additional MT (A, SR, B, AngioJet or combination; not specified) | n = 37; standard care | 3 | mRS 0–2: 22 vs. 30 (p = 1.0) | n = 6 (vs. n = 5) | n = 11; full (n = 8), partial (n = 3) | n = 25 | n = 0 | n = 21 | n = 25 | n = 7 | NN | n = 9 | NN |
| Siddiqui et al. (2014) [40] | retrosp | 1995–2012 | 63 (NN) | SVT (anticoagulation) and either coma (GCS < 9), ICH or deterioration | n = 29 | n = 63; n = 29 LT only, n = 34 MT (plus LT n = 27; AngioJet n = 28, A n = 3, SR n = 1. B n = 2) [LT bolus and continuously depending on recanalization] | NA | 3 | n = 53; mRS 0–1: n = 33 | n = 11 | full (n = 21), partial (n = 18) | NN | NN | NN | NN | NN | n = 5 | n = 3 | NN |
| Guo et al. (2020) [41] | retrosp | 2010–2019 | 56 (227 sc) | SVT under anticoagulation; ICH, lack of improvement or deterioration of symptoms | n = 56 | n = 56; LT only (n = 41; duration: 7 days); additional MT (n = 15) [SR n = 5, A n = 3, B n = 3, combined n = 4) | NA | 6 | n = 54; mRS 0–2: n = 49 | n = 3 | (full and partial); LT n = 39; MT n = 14 | NN | NN | NN | NN | NN | n = 0 | LT n = 7, MTn = 1 | NN |
| Andersen et al. (2020) [42] | retrosp | 2007–2018 | 28 (NN) | SVT under anticoagulation; clinical deterioration and/or impaired consciousness | n = 18 |
n = 28; LT (n = 26; 12–72 h), A (n = 3), SR (n = 3), combined (more than 2 techniques; n = 4) incl. PTA and stenting (n = 2) |
NA | 6 | mRS 0–2: n = 20 | n = 5 | full (n = 15), partial (n = 11), no (n = 2) | n = 16 | n = 15 | n = 15 | n = 16 | n = 7 | n = 1 (retrop. hem.) | n = 8 | NA |
| Yang et al. (2019) [43] | pros CS | 2014–2018 | 21 (27 sc) | SVT (anticoagulation) with: ICH, mental status impairment, coma (GCS < 9), DV thrombosis, cortical venous thrombosis, intracranial hypertension, or papilledema | NN | NN | NA | 12 | mRS 0–2: n = 21 | n = 0 | full (n = 5), partial (n = 9) | n = 16 | n = 0 | n = 17 | n = 19 | n = 14 | NN | NN | NN |
| Yang et al. (2021) [44] | retrosp | 2017–2019 | 23 (NN) | SVT (anticoagulation) with: deterioration after the initiation of anticoagulation, lethargy or coma, venous infarction with hemorrhagic transformation or ICH | n = 8 | n = 23; MT (B) plus LT (urokinase) | NA | 6 | n = 21; mRS 0–1: n = 21 | n = 0 | full (n = 9), partial (n = 13) | n = 20 | n = 11 | n = 21 | n = 21 | NN | n = 2 (failure) | n = 1 | NN |
| Stam et al. (2008) [45] | pros CS | NN | 20 (NN) | SVT (heparin) with assumed poor prognosis: altered mental status, coma, extensive edema, ICH, infarction | n = 14 | n = 20, LT only (n = 15 additional MT [rheolytic catheter]) | NA | 3 (−6) | mRS 0–2: n = 12 | n = 6 | NN | NN | NN | NN | NN | n = 20 | NN | n = 1 (ICH progress) | NN |
| Lu et al. (2019) [46] | retrosp | 2015–2018 | 14 (NN) | SVT (best medical treatment); decision of treatment team | n = 1 | n = 14; MT (SR or A, combination), additional stenting in n = 5 (in case of failure of SR or A; re- occlusion) | NA | 2 (−16) | n = 5 (stenting); mRS 0–1: n = 4 | n = 0 | NN | n = 0 | n = 0 | n = 0 | n = 5 | NA | NN | n = 2 (increase) | NN |
| Qureshi et al. (2018) [47] | retrosp | 2006–2011/2016/2017 | 14 (NN) | SVT (anticoagulation), deterioration | n = 7 | n = 13 LT, MT: AngioJet n = 9, B n = 2, SR n = 2 (combined) [LT bolus, up to 22 h after MT in case of incomplete recanalization] | NA | 1 (−3) | mRS 0–2: n = 10 | n = 1 | full (n = 3), partial (n = 4) | n = 10 | n = 1 | n = 10 | n = 13 | n = 0 | NN | NN | NN |
| Styczen et al. (2019) [48] | retrosp | 2011–2018 | 13 (NN) | SVT (heparin) with assumed poor prognosis: altered mental status or coma, involvement of DV, ICH | n = 7 | n = 13; MT (A n = 4, A plus SR n = 9) | NA | 3 (median) | mRS 0–2: n = 12 | n = 1 | full (n = 4), partial (n = 7) | n = 9 | n = 5 | n = 7 | n = 10 | NN | n = 1 (perf) | n = 3 | NN |
| Mokin et al. (2015) [49] | retrosp | 2010–2013 | 13 (NN) | SVT (plus/minus anticoagulation), decision of treatment team | NN | n = 13 (LT n = 2 [sinus or ia]; A n = 2; LT plus A n = 3; A plus SR n = 2; AngioJet n = 2, combined n = 3) | NA | 3 | n = 11; mRS 0–2: n = 5 | n = 1 | full (n = 5), partial (n = 8) | n = 10 | n = 7 | n = 0 | n = 11 | n = 0 | NN | NN | NN |
| Dashti et al. (2011) [50] | retrosp | 2009/2010 | 13 (NN) | NA; decision of treatment team | NN | n = 13; AngioJet | NA | NN | n = 9; mRS 0–1: n = 7 | n = 2 | full (n = 6), partial (n = 7) | n = 9 | NN | NN | NN | NN | NN | NN | n = 1 (re- occl) |
| Lee et al. (2016) [51] | retrosp | 2008–2015 | 10 (NN) | SVT under anticoagulation; MT in case of ICH, deep venous thrombosis, deterioration | n = 9 | n = 10; MT (B plus A [combination]) plus LT (n = 3; before 2013; bolus) | NA | 3 | mRS 0–1: n = 8 | n = 1 | NN | n = 6 | n = 3 | n = 5 | n = 9 | NA | n = 0 | n = 1 | NN |
| Poulsen et al. (2013) [52] | retrosp | 2007–2011 | 9 (NN) | SVT (anticoagulation), deterioration | n = 4 | n = 6 MT (n = 5 prior LT [24–72 h]; not specified); n = 5 LT only | NA | 6 | mRS 0–2: n = 8 | n = 1 | full (n = 2), partial (n = 4) | n = 5 | n = 4 | n = 0 | n = 9 | n = 0 | n = 0 | n = 1 (SAH) | n = 3 (hem. [eVD]) |
| Mammen et al. (2017) [53] | retrosp | (4 years) | 8 (243 sc) | SVT (anticoagulation), no response or deterioration | n = 1 | n = 8 (MT, A [Penumbra] plus additional B (n = 7) and LT (n = 3; bolus) | NA | 6 | mRS 0–2: n = 5 | n = 1 | full (n = 3), partial (n = 4) | n = 5 | n = 5 | n = 2 | n = 6 | n = 3 | n = 0 | n = 0 | n = 0 |
| Peng et al. (2021) [54] | retrosp | 2017–2020 | 7 (NN) | SVT (anticoagulation); one risk factor (poor outcome): coma (GCS < 9), ICH, DV thrombosis | n = 4 | n = 7 MT (SR; plus A n = 4; plus B n = 4; plus heparin n = 4, plus LT n = 1 [bolus]) | NA | 3 | mRS 0–2: n = 6 | n = 0 | full (n = 4), partial (n = 3) | n = 7 | n = 0 | n = 4 | n = 5 | n = 0 | n = 0 | n = 0 | n = 0 |
| Mehdi et al. (2020) [55] | retrosp | 2018/2019 | 7 (NN) | SVT (anticoagulation), clinical and imaging deterioration (no signs of herniation) | n = 3 | n = 7 (MT; A) plus LT (n = 4; bolus 20 min) | NA | 1 (3, 6) | mRS 0–1: n = 5 | n = 0 | partial (n = 7) | n = 6 | n = 4 | n = 0 | n = 3 | n = 0 | n = 0 | n = 0 | n = 0 |
| Tsang et al. (2018) [56] | CS | 2014–2018 | 6 (NN) | SVT (anticoagulation) with deterioration or ICH | NN | n = 6; MT (A [Penumbra]) plus LT (urokinase) | NA | 3 | mRS 0–1: n = 5 | n = 1 | NN | n = 5 | n = 2 | n = 3 | n = 4 | NN | n = 0 | n = 0 | n = 0 |
| Jankowitz et al. (2013) [19] | retrosp | 2009–2011 | 6 (27 sc) | SVT (best medical treatment); clinical (progressive deficits, coma) or radiological (hem., edema) deterioration | n = 4 | n = 6; MT (A) (n = 6), additional LT n = 4 (bolus) | NA | 6 | mRS 0–2: n = 4 | n = 1 | n = 6 | n = 3 | n = 2 | n = 1 | n = 3 | NA | n = 0 | NN | n = 0 |
| Yue et al. (2010) [57] | retrosp | 2005–2008 | 6 (28 sc) | SVT (anticoagulation) with deterioration or assumed poor prognosis: coma, altered mental state, seizure, space-occupying lesions (edema or [hemorrhagic] infarct) | n = 2 | n = 6; MT (B) plus ia T (urokinase) | NA | 3 (−6) | mRS 0: n = 5 | n = 1 | full (n = 5) | n = 6 | n = 4 | n = 6 | n = 6 | n = 20 | n = 0 | n = 0 | n = 0 |
* catheter complications such as perforation; ** ICH; new hemorrhage or worsening of a pre-existing intracerebral hemorrhage; n, number of patients; N, total number of patients (patients screened: indicated by [sc]; ICH, intracerebral hemorrhage; FU, follow-up; Recanal., recanalization; SSS, sagittal superior sinus; SS, straight sinus; S Sig, sigmoid sinus; TS, transverse sinus; DV, deep cerebral veins; RCT, randomized controlled trial; restrosp, retrospective, pros, prospective; CS, case series; GCS, Glasgow Coma Scale; SVT, sinus or cerebral vein thrombosis; MT, mechanical thrombectomy; NN, unknown; NA, not applicable; LT, local (intrasinus) thrombolysis; A, aspiration thrombectomy; SR, stent retriever thrombectomy; B, balloon guided thrombectomy or angioplasty; PTA, percutaneous transluminal angioplasty; ia, intra-arterial; T, thrombolysis; mRS, modified Rankin Scale; hem, hemorrhagic or hemorrhage; retrop., retroperitoneal; compl, complication; perf, perforation; SAH, subarachnoid hemorrhage; occl, occluison.