title: Novel factor xa inhibitor for the treatment of cerebral venous and sinus thrombosis: first experience in 7 patients.
abstract: OBJECTIVE
  Thrombosis of cerebral veins and sinus (cerebral venous thrombosis) is a rare stroke pathogenesis. Pharmaceutical treatment is restricted to heparin and oral anticoagulation with vitamin K antagonists (VKAs).
  
  
  METHODS
  Between January 2012 and December 2013, we recorded data from our patients with cerebral venous thrombosis. The modified Rankin scale was used to assess clinical severity; excellent outcome was defined as modified Rankin scale 0 to 1. Recanalization was assessed on follow-up MR angiography. Patients were then divided into 2 treatment groups: phenprocoumon (VKA) and a novel factor Xa inhibitor. Clinical and radiological baseline data, outcome, recanalization status, and complications were retrospectively compared.
  
  
  RESULTS
  Sixteen patients were included, and 7 were treated with rivaroxaban. Overall outcome was excellent in 93.8%, and all patients showed at least partial recanalization. No statistical significant differences were found between the groups, except the use of heparin before start of oral anticoagulation (P=0.03). One patient in the VKA and 2 patients in the factor Xa inhibitor group had minor bleeding (P=0.55) within the median (range) follow-up of 8 months (5-26).
  
  
  CONCLUSIONS
  Factor Xa inhibitor showed a similar clinical benefit as VKA in the treatment of cerebral venous thrombosis. Further systematic prospective evaluation is warranted.
authors: From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany.
authors: Christina
authors: C
authors: Geisbüsch
authors: From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany.
authors: Daniel
authors: D
authors: Richter
authors: From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany.
authors: Christian
authors: C
authors: Herweh
authors: From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany.
authors: Peter A
authors: PA
authors: Ringleb
authors: From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany. simon.nagel@med.uni-heidelberg.de.
authors: Simon
authors: S
authors: Nagel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D010644:Phenprocoumon / Q000627:therapeutic use*; D000069552:Rivaroxaban; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy*; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D009025:Morpholines; D013876:Thiophenes; D000069552:Rivaroxaban; D010644:Phenprocoumon
keywords: cerebral veins; rivaroxaban; thrombosis