Journal article
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, v 8(7), 102605
Oct 2024
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Abstract
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 to those participants with non-CSVT venous thromboembolism (VTE).
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 <21 years. Patient and thrombus characteristics, treatments, and outcomes for patients diagnosed with CSVT were compared to patients with non-CSVT VTE.
CSVT was diagnosed in 75/532 (14%), 25 of whom received 6 weeks of anticoagulant treatment and 50 received 3 or more months. When compared to non-CSVT VTE, CSVT was more likely to occur in neonates and young children, was associated with infection in general and acute head/neck infection in particular, and less likely to be central venous catheter-related. 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 two treatment durations.
CSVT is most common in neonates and young children and those with acute head and neck infections. A six-week anticoagulation treatment course appears to be safe (no clinically relevant bleeding) and effective (no difference in symptomatic recurrent VTE) for acute provoked pediatric CSVT. Nevertheless, given the nature of a subpopulation analysis, these findings should be interpreted with caution.
•Data on treatment and outcomes of cerebral sinovenous thrombosis (CSVT) in children are limited•This is a subgroup (CSVT) analysis from the Kids-DOTT trial•CSVT is most common in neonates and young children and with head and neck infections•Six-weeks of anticoagulation appears to be safe and effecitve for acute provoked pediatric CSVT
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Details
- Title
- Clinical Characteristics, Treatment, and Outcomes of Provoked Acute Cerebral Sinovenous Thrombosis in Patients <21 Years Old: Findings from the Kids-DOTT Multinational Trial
- Creators
- Gary M. Woods - Emory UniversityAlexandra Miller - Johns Hopkins All Children's HospitalMaua Mosha - Johns Hopkins All Children's HospitalChristoph Male - Medical University of ViennaAnupam Verma - University of UtahNicole Kucine - Department of Pediatrics, Weill Cornell Medical College and Presbyterian/Weill Cornell, New York, NY, USAChristine Sabapathy - McGill University Health CentreKisha Beg - University of OklahomaSanjay Ahuja - Case Western Reserve UniversityDeepti Raybagkar - Drexel UniversityKerry Hege - Indiana University School of MedicineClara Lo - Stanford University School of MedicineRukhmi Bhat - Northwestern UniversityThomas Abshire - Medical College of WisconsinNeil A. Goldenberg - Johns Hopkins University School of Medicine
- Publication Details
- Research and practice in thrombosis and haemostasis, v 8(7), 102605
- Publisher
- Elsevier
- Number of pages
- 7
- Grant note
- U01 grants (Clinical Coordinating Center, Data Coordinating Center) from the National Institutes of Health, National Heart Lung and Blood Institute (NIH NHLBI)
The Kids-DOTT trial was supported by 2 U01 grants (Clinical Coordinating Center, Data Coordinating Center) from the National Institutes of Health, National Heart Lung and Blood Institute (NIH NHLBI), and previously via a American Society of Hematology Bridge Grant, an Institutional Research Grant from the Johns Hopkins All Children's Foundation, an NIH NHLBI K23 award, and a Hemophilia and Thrombosis Research Society Thrombosis Studies Award.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:001360115500001
- Scopus ID
- 2-s2.0-85208758423
- Other Identifier
- 991021932803704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Hematology
- Peripheral Vascular Disease