Mechanical prophylaxis of venous thrombosis in patients undergoing craniotomy: A randomized trial

Abstract

A randomized, prospective clinical trial of 70 patients undergoing craniotomy was performed to compare and evaluate two forms of mechanical prophylaxis of deep vein thrombosis. Thirty-eight patients received antiembolism stockings, whereas 32 patients received external pneumatic compression. Prophylaxis was begun preoperatively and continued intraoperatively and post-operatively until the patients were ambulatory. Impedance plethysmography was used to detect deep vein thrombosis both preoperatively and postoperatively. Two patients, one from each group, developed thromboembolic complications postoperatively. Impedance plethysmography showed false-positive findings in two additional patients. There were no deaths. The data suggest that either form of mechanical prophylaxis is effective against the development of deep vein thrombosis in this high-risk patient population.

Prophylaxis for Venous Thrombo-Embolism in Neurocritical Care: A Critical Appraisal

“…Turpie et al [26] randomized patients (n = 239; 117 with brain tumors) to CS alone, CS in combination with ICD, or no prophylaxis and found a reduction in frequency of DVT from 20% in patients without prophylaxis to 9% in both treatment arms. Another randomized study [27] compared ICD with ICD + CS and found similar rates of DVT in 70 patients of whom 39 underwent surgery for brain neoplasm. In contradistinction to the two aforementioned studies, Wautrecht et al [28] randomized 23 patients undergoing surgery exclusively for brain tumors and reported that ICD + CS was superior to CS alone in decreasing the incidence of post-operative DVT (40% in the CS group vs. 0% with combined CS + ICD).…”

Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors: Results from a single center over a 10year period

“…), early ambulation, and medical treatment with various preparations of heparin, enoxaparin, or other anticoagulants [23][24][25][26][27][28]. In patients who have undergone resection of an intracranial lesion, many neurosurgeons remain reluctant to prescribe prophylactic anticoagulants due to the risk of post-operative intracranial hemorrhage [1,3,11,24,[29][30][31][32][33][34][35][36][37][38][39][40].…”

Venous thromboembolism occurs infrequently in meningioma patients receiving combined modality prophylaxis

“…In 2 commonly cited series, patients received only leg wrapping and early ambulation for VTE prophylaxis. 7,8 In neurosurgical patients, the use of pneumatic compression devices has been shown to decrease VTE rates by up to 50%, 13,14 and low-dose heparin provides an additional 38% relative risk reduction.…”