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Six patients had favorable outcome with mRS 0 or 1 at 90 days postprocedure; one remained neurologically devastated. Endovascular treatment by an experienced interventionalist may be safe and effective in severe cases of CVST in children failing frontline therapy. Children with radiographic or clinical progression despite anticoagulation may be considered for endovascular intervention in a timely manner. Endovascular treatment by an experienced interventionalist may be safe and effective in severe cases of CVST in children failing frontli