Venous Thrombotic and Thromboembolic Considerations in Stroke: An Expert Meeting Report on Future Directions for Clinical Trials

作者：D. Vikulova, Vanessa Dizonno, Lily Zhou, Johnathon Gorman, Ronda Lun, Katrina Hannah D. Ignacio, Cheryl Bushnell, Aravind Ganesh, Aristeidis H. Katsanos, Luciano A. Sposato, Sara Rosa, Alejandro Fuerte-Hortigon, Diana Aguiar de Sousa, Cheryl Carcel, Nishita Singh, Tony Wan, Bethany Samuelson Bannow, Hetao Bian, Chen Chen, JM Coutinho, A I Demchuk, Darshan Doshi, Mehdi Farhoudi, Ana Catarina Gaspar Fonseca, Vivian Fu, M Heldner, Menglu Ouyang, Emily Ramage, Ivy Sebastian, Ronen R. Leker, C M Anderson, Bijoy Menon, Thalia S. Field · 发表于：International Journal of Stroke · 年份：2026 · DOI：10.1177/17474930261473348 · 研究领域：Cardiovascular and Diving-Related Complications、Venous Thromboembolism Diagnosis and Management、Cerebral Venous Sinus Thrombosis

BACKGROUND: Venous thrombosis and venous thromboembolism (VTE) are important causes and complications of stroke. They may complicate acute stroke as deep venous thrombosis or pulmonary embolism (DVT/PE), contribute causally to ischemic stroke through paradoxical embolism from a patent foramen ovale (PFO), or present directly as cerebral venous thrombosis (CVT). Despite shared pathophysiological features and overlapping antithrombotic strategies, these conditions are typically considered separately, fragmenting evidence and limiting the exchange of concepts. PURPOSE: We therefore convened experts across both stroke neurology and thrombosis medicine fields to examine these conditions under a unifying venous theme and define priorities for future clinical trials. METHODS: Thirty-two stroke and thrombosis clinicians and researchers identified research priorities across three domains: prevention of VTE after stroke, secondary prevention after PFO-related stroke, and acute and long-term management of CVT. Structured discussions were guided by the PICO (Population, Intervention, Comparison, Outcome) framework, followed by a Delphi survey to establish consensus. Priority questions centered on the balance between thrombosis prevention and bleeding risk and the optimal timing, duration, and choice of DVT/PE prophylaxis after stroke; the optimal antithrombotic strategy for patients awaiting or forgoing PFO closure; and, for CVT, the role of endovascular therapy in severe disease and the...