Weller, JohannesKrzywicka, Katarzynavan de Munckhof, AnitaDorn, FranziskaAlthaus, KatharinaBode, Felix J.Bandettini di Poggio, MonicaBuck, BrianKleinig, TimothyCordonnier, CharlotteDizonno, VanessaDuan, JiangangElkady, AhmedChew, Beng Lim AlvinGarcia-Esperon, CarlosField, Thalia S.Legault, CatherineMorin Martin, MarMichalski, DominikPelz, JohannSchoenenberger, SilviaNagel, SimonPetruzzellis, MarcoRaposo, NicolasSkjelland, MonaZimatore, Domenico SergioAaron, SanjithSanchez van Kammen, Maytede Sousa, Diana AguiarLindgren, ErikJood, KatarinaScutelnic, AdrianHeldner, Mirjam R.Poli, SvenArauz, AntonioConforto, Adriana B.Putaala, JukkaTatlisumak, TurgutArnold, MarcelCoutinho, Jonathan M.Günther, AlbrechtZimmermann, JulianFerro, José2024-03-062024-03-062023Eur Stroke J. 2024 Mar;9(1):105-1132396-9873http://hdl.handle.net/10451/63209© European Stroke Organisation 2023.Introduction: There is little data on the role of endovascular treatment (EVT) of cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT). Here, we describe clinical characteristics and outcomes of CVST-VITT patients who were treated with EVT. Patients and methods: We report data from an international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 6 March 2023. VITT was defined according to the Pavord criteria. Results: EVT was performed in 18/136 (13%) patients with CVST-VITT (92% aspiration and/or stent retrieval, 8% local thrombolysis). Most common indications were extensive thrombosis and clinical or radiological deterioration. Compared to non-EVT patients, those receiving EVT had a higher median thrombus load (4.5 vs 3). Following EVT, local blood flow was improved in 83% (10/12, 95% confidence interval [CI] 54-96). One (6%) asymptomatic sinus perforation occurred. Eight (44%) patients treated with EVT also underwent decompressive surgery. Mortality was 50% (9/18, 95% CI 29-71) and 88% (8/9, 95% CI 25-66) of surviving EVT patients achieved functional independence with a modified Rankin Scale score of 0-2 at follow-up. In multivariable analysis, EVT was not associated with increased mortality (adjusted odds ratio, 0.66, 95% CI 0.16-2.58). Discussion and conclusion: We describe the largest cohort of CVST-VITT patients receiving EVT. Half of the patients receiving EVT died during hospital admission, but most survivors achieved functional independence.engCOVID-19Intracranial thrombosisThrombectomyThrombocytopeniaVaccinationVenous thrombosisjournal article10.1177/239698732312023632396-9881