Multicenter Study

. 2025 Apr 8;12(1):16.

doi: 10.1186/s40779-025-00605-3.

Endovascular treatment for cerebral venous thrombosis: a multicenter study in China

He-Tao Bian^#¹, Xia Wang^#², Gui-You Liu¹, Chen Zhou¹, Ran Meng³, Lan Liu⁴, Jian-Gang Duan⁵, Feng Yan⁶, Chuan-Hui Li⁷, Min Li³, Wen Hui⁸, Xu-Xiang Zhang⁹, Dong Zhao¹⁰, Ya-Peng Li¹¹, Qi Fang¹², De-Zhi Kang¹³, Hong-Liang Zeng¹⁴, Zhi-Jian Liang¹⁵, Zheng-Hao Shi¹⁶, Wei Yue¹⁷, Qin-Jian Sun¹⁸, Gui-Sheng Chen¹⁹, Jian-Long Song²⁰, Zhong-Rui Yan²¹, Qiu-Hong Ji²², Kai-Jie Wang²³, Lu-Sha Tong²⁴, Xiao Hu²⁵, Wen-Feng Cao²⁶, Wei Yan²⁷, Rui-Jiang Gao²⁸, Qi Li²⁹, Jian-Yi Wang³⁰, Yi Liu³¹, Bao-Jun Wang³², Xiao-Hua Wang³³, Sheng-Tao Yao³⁴, Ye Lang³⁵, Hai-Peng Li³⁶, Craig S Anderson^{2

37}, Xun-Ming Ji^{38

39}; RETAIN-CH Investigators and Coordinators

Affiliations

¹ Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China.
² The George Institute for Global Health, University of New South Wales, Sydney, 2000, Australia.
³ Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
⁴ School of Statistics, University of Minnesota at Twin Cities, Minneapolis, MN, 55455, USA.
⁵ Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁶ Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁷ Department of Neurology and Stroke Center, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁸ Department of Science and Technology, West China Hospital of Sichuan University, Chengdu, 610041, China.
⁹ Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
¹⁰ Department of Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100013, China.
¹¹ Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China.
¹² Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
¹³ Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.
¹⁴ Department of Neurology, Ganzhou People's Hospital, Ganzhou, 341000, Jiangxi, China.
¹⁵ Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Xining, 530021, China.
¹⁶ Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
¹⁷ Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, China.
¹⁸ Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
¹⁹ Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, 750001, China.
²⁰ Department of Neurology, the First Affiliated Hospital of USTC, Hefei, 230001, China.
²¹ Department of Neurology, Jining First People's Hospital, Jining, 272113, Shandong, China.
²² Department of Neurology, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
²³ Department of Neurology, Tangshan Gongren Hospital, Tangshan, 063099, Hebei, China.
²⁴ Department of Neurology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
²⁵ Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
²⁶ Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, 330006, China.
²⁷ Department of Neurology, the First People's Hospital of Kashi, Kashi, 84000, Xinjiang, China.
²⁸ Department of Neurology, Inner Mongolia People's Hospital, Hohhot, 010010, China.
²⁹ Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
³⁰ Department of Neurology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
³¹ Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, 030012, China.
³² Department of Neurology, Baotou Central Hospital Inner Mongolia, Baotou, 014040, Inner Mongolia Autonomous Region, China.
³³ Department of Neurology, Qujing No. 1 Hospital, Qujing, 655000, Yunnan, China.
³⁴ Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563099, Guizhou, China.
³⁵ Department of Neurology, Shengli Oilfield Central Hospital, Dongying, 257100, Shandong, China.
³⁶ Department of Neurology, the First People's Hospital of Chenzhou, Chenzhou, 424300, Hunan, China.
³⁷ Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China.
³⁸ Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China. jixm@ccmu.edu.cn.
³⁹ Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. jixm@ccmu.edu.cn.

^# Contributed equally.

PMID: 40200369
PMCID: PMC11978133
DOI: 10.1186/s40779-025-00605-3

Multicenter Study

Endovascular treatment for cerebral venous thrombosis: a multicenter study in China

He-Tao Bian et al. Mil Med Res. 2025.

. 2025 Apr 8;12(1):16.

doi: 10.1186/s40779-025-00605-3.

Authors

Affiliations

¹ Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China.
² The George Institute for Global Health, University of New South Wales, Sydney, 2000, Australia.
³ Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
⁴ School of Statistics, University of Minnesota at Twin Cities, Minneapolis, MN, 55455, USA.
⁵ Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁶ Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁷ Department of Neurology and Stroke Center, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
⁸ Department of Science and Technology, West China Hospital of Sichuan University, Chengdu, 610041, China.
⁹ Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
¹⁰ Department of Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100013, China.
¹¹ Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China.
¹² Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
¹³ Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.
¹⁴ Department of Neurology, Ganzhou People's Hospital, Ganzhou, 341000, Jiangxi, China.
¹⁵ Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Xining, 530021, China.
¹⁶ Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
¹⁷ Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, China.
¹⁸ Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
¹⁹ Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, 750001, China.
²⁰ Department of Neurology, the First Affiliated Hospital of USTC, Hefei, 230001, China.
²¹ Department of Neurology, Jining First People's Hospital, Jining, 272113, Shandong, China.
²² Department of Neurology, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
²³ Department of Neurology, Tangshan Gongren Hospital, Tangshan, 063099, Hebei, China.
²⁴ Department of Neurology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
²⁵ Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
²⁶ Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, 330006, China.
²⁷ Department of Neurology, the First People's Hospital of Kashi, Kashi, 84000, Xinjiang, China.
²⁸ Department of Neurology, Inner Mongolia People's Hospital, Hohhot, 010010, China.
²⁹ Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
³⁰ Department of Neurology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
³¹ Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, 030012, China.
³² Department of Neurology, Baotou Central Hospital Inner Mongolia, Baotou, 014040, Inner Mongolia Autonomous Region, China.
³³ Department of Neurology, Qujing No. 1 Hospital, Qujing, 655000, Yunnan, China.
³⁴ Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563099, Guizhou, China.
³⁵ Department of Neurology, Shengli Oilfield Central Hospital, Dongying, 257100, Shandong, China.
³⁶ Department of Neurology, the First People's Hospital of Chenzhou, Chenzhou, 424300, Hunan, China.
³⁷ Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China.
³⁸ Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China. jixm@ccmu.edu.cn.
³⁹ Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. jixm@ccmu.edu.cn.

^# Contributed equally.

PMID: 40200369
PMCID: PMC11978133
DOI: 10.1186/s40779-025-00605-3

Abstract

Background: Endovascular treatment (EVT) is gaining popularity for the management of severe forms of cerebral venous thrombosis (CVT), but the evidence supporting its efficacy and safety is limited.

Methods: This multicenter study included patients with CVT admitted to 104 hospitals in 31 provinces/cities in China between January 2018 and June 2022. Propensity score weighting models were used to adjust baseline confounding variables to determine the association of EVT on the primary outcome of good functional status, defined as score 0 - 1 on the modified Rankin Scale after hospital discharge.

Results: Of 3063 patients identified through hospital records searches, 2774 adults [age (42 ± 15.8) years, female 50.3%] fulfilled eligibility criteria and agreed to be included, of whom 449 (16.2%) received EVT and 2325 (83.8%) received standard care. There was no significant difference between the EVT group and the standard care group in terms of the possibility of good functional recovery [weighted risk ratio = 1.00, 95% confidence interval (CI) 0.96 - 1.03]. Similarly, there was no difference in the likelihood of death at hospital discharge (weighted risk ratio = 1.91, 95% CI 0.91 - 3.68). In subgroup analysis, the possibility of good functional recovery was lower in patients with intracerebral hemorrhage (weighted risk ratio = 0.88, 95% CI 0.79 - 0.98; P for interaction = 0.01) and seizures (weighted risk ratio = 0.86, 95% CI 0.76 - 0.95; P for interaction = 0.03).

Conclusion: In this large nationwide study, EVT was not associated with improved functional outcomes compared to standard care in patients with CVT.

Keywords: Cerebral venous thrombosis (CVT); Efficacy; Endovascular treatment (EVT); Safety; Standard care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was registered at ClinicalTrials.gov (NCT05448248). The study was centrally approved by the ethics committee of Hunan Brain Hospital (Z2017006). Consent for publication: Not applicable. Competing interests: CSA reports grant applications from the National Health and Medical Research Council (NHMRC) of Australia, the Medical Research Foundation (MRF) of the United Kingdom, and consulting fees from AstraZeneca.

Figures

**Fig. 1**
Study flow chart. RETAIN-CH multicenter registry study of cerebral venous thrombosis in China, NIHSS National Institutes of Health Stroke Scale, mRS modified Rankin Scale, EVT endovascular treatment

**Fig. 2**
Subgroup analyses of endovascular treatment (EVT) for cerebral venous thrombosis (CVT). Scores on the modified Rankin Scale (mRS) of functional recovery range from 0 to 6, with higher scores indicating more severe disability and 6 indicating death. Scores on National Institutes of Health Stroke Scale (NIHSS) range from 0 to 42, with higher scores indicating greater neurologic deficits. CI confidence interval, ICH intracranial hemorrhage, SAH subarachnoid hemorrhage

See this image and copyright information in PMC

References

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Endovascular treatment for cerebral venous thrombosis: a multicenter study in China

Affiliations

Endovascular treatment for cerebral venous thrombosis: a multicenter study in China

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical