Prevention of Venous Thromboembolism in Neurosurgery

Collen, Jacob; Jackson, Jeffrey L.; Shorr, Andrew F.; Moores, Lisa K.

doi:10.1378/chest.08-0023

Cited by 163 publications

(126 citation statements)

References 47 publications

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“…The authors concluded that the deleterious effects of ICH are greater than the benefits from pharmacologic anticoagulation on VTE morbidity and mortality, and that overall outcomes are best with mechanical prophylaxis alone. A meta-analysis conducted in 2008 support the findings by Danish et al [13].…”

Section: Introductionsupporting

confidence: 66%

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis

Henwood

Kennedy

Thomson

et al. 2011

J Thromb Thrombolysis

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Section: Introductionsupporting

confidence: 66%

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis

Henwood

Kennedy

Thomson

et al. 2011

J Thromb Thrombolysis

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“…Mechanical methods such as compression stockings, intermittent compression devices and early mobilization are widely used and reported to reduce the incidence of DVT and PE (6,11,21). Mechanical prophylaxis assisted by the use of heparin or low-molecular weight heparin further reduces the incidence of these conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Given the possibility of a surgical intervention, it is questionable to use an antiaggregant and anticoagulant agent for DVT and PE prophylaxis due to high risk of bleeding. Pharmacological agents might result in catastrophic complications in the peri-and postoperative period and their use is therefore not considered to be beneficial (1,6,7,23,18,19). Although absolute and relative indications of vena cava filters are still debatable, their prophylactic use in patients with neurosurgical problems has not been reported thoroughly in the literature (8,10,20,22,24,26,28).…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacological prophylaxis with lowered dose low molecular weight heparin is reported to be a safer alternative but the use of these agents might also be hazardous (1,6,7,23). Vena cava filters (VCF) offer an alternative-adjuvant treatment option for prevention of the pulmonary embolism in high risk patient groups where pharmacological prophylaxis is risky or contraindicated (1,4,26).…”

Section: Introductionmentioning

confidence: 99%

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Vena cava filters are not superior to low molecular weight heparin in venous thromboembolism prophylaxis: a study on long term immobilized neurosurgical patients

Akmangit¹,

Dağlıoğlu²,

Uyanık³

et al. 2014

Turkish Neurosurgery

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AIm: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most frequent surgical problems and associated with high morbidity and mortality. Neurosurgical patients constitute a unique group where prophylaxis with anticoagulant and antiaggregant agents are relatively contraindicated due to the natural course of vascular problems such as aneurysms, hemorrhagic tumors or hematomas or increased vulnerability to complex spinal surgeries and trauma. mAterIAl and methOds: We included 67 patients predicted to be immobilized for 2 or more months in this retrospective analysis. A vena cava filter was inserted between the first and seventh postoperative day in 40 patients in a prophylactic manner whereas 27 patients received low dose heparin for the same purpose. The patients were evaluated for symptomatic DVT or PE.results: Percutaneous insertion was performed for all filters without any complication. DVT occurred in two patients of the filter group and 1 patient of the heparin group. There was no PE recorded in any patient of either group. Patients were followed up for 22 months in the filter and 16 months in the heparin group. COnClusIOn:We conclude that prophylactic filter use in high risk neurosurgical patients is not beneficial and not superior to low-molecularweight heparin use. Nevertheless, it is reasonable to prevent PE in patients with proven DVT who have no contraindication for anticoagulant drugs.KeywOrds: Deep venous thrombosis, Venous thromboembolism, Vena cava filter, Low molecular weight heparin, Pulmoner embolism prophylaxis, Neurosurgical patients ÖZ AmAÇ: Derin ven trombozu ve pulmoner embolizm yüksek morbidite ve mortaliteyle seyreden en sık cerrahi problemler arasında yer alır. Anevrizma gibi vasküler problemler, hemorajik tümörler, hematom, kompleks spinal cerrahi ve travma gibi nöroşirürjiye ait hastalıklar antiagregan ve antikoagülan tedavinin göreceli olarak kontrendike olduğu özel bir grubu oluşturmaktadır. yÖntem ve GereÇler: Bu retrospektif çalışmada, 2 ay veya daha uzun süre immobilize olması beklenen 67 hastanın analizi yapılmıştır. Vena kava filtreleri 40 hastada postoperatif bir ile yedinci günde proflaktik amaçla yerleştirildi. 27 hastada ise aynı amaçla düşük moleküler ağırlıklı heparin kullanıldı. Hastalar yattıkları süreçte ve izlemde semptomatik derin ven trombozu (DVT) ve pulmoner emboli (PE) açısından takip edildi.BulGulAr: Bütün filtreler perkütan yolla yerleştirildi ve işleme ait herhangi bir komplikasyon gelişmedi. Filtre grubunda 2, heparin grubunda 1 hastada DVT gelişti. Her iki grupta PE saptanmadı. Hastalar filtre grubunda ortalama 22 ay, heparin grubunda 16 ay süreyle takip edildi. sOnuÇ: Yüksek riskli nöroşirürji hastalarında prolaktik filtre kullanımının düşük moleküler ağırlıklı heparin kullanımına üstün olmadığı düşünüldü. Buna rağmen DVT'si kanıtlanmış ve antikoagülan ilaçların kontrendike olduğu durumlarda PE'yi önlemede etkin olduğu açıktır.

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“…El paciente neuroquirúrgico es conside rado de alto riesgo para el TEV, pero tam bién está en igual riesgo para desarrollar hemorragias 109 . Las guías ACCP 110 estable cen que el paciente que va a ser sometido a un abordaje neuroquirúrgico significativo debería recibir tromboprofilaxis de manera rutinaria junto con compresión neumática intermitente (CNI).…”

Section: Manejo De Tromboembolismo Venoso (Tev)unclassified

Manejo perioperatorio de tumores intracraneales: rol del neurocirujano

Polo-Torres¹,

Alvis-Miranda²,

Villa-Delgado³

et al. 2013

Anales Sis San Navarra

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revisiones0 Manejo perioperatorio de tumores intracraneales: rol del neurocirujanoPerioperative management of intracranial tumours: the neurosurgeon's role C. Polo-Torres, H.r. Alvis-Miranda, r. villa-Delgado, L.r. Moscote-salazar resUMen El manejo perioperatorio de los pacientes con tu mores cerebrales es un reto para el neurocirujano y todo el equipo quirúrgico. El médico debe considerar factores como el tipo de tumor, la extensión de la enfer medad, el tratamiento recibido, la presencia de comor bilidades y el pronóstico de la patología. La ejecución correcta de todos los aspectos implicados en el manejo perioperatorio en pacientes con tumores intracranea les contribuirá a prolongar la vida y a mejorar la calidad de vida de los pacientes.Palabras clave. Tumores cerebrales. Evaluación pre ope ratoria. Neurocirugía. ABsTrACTThe perioperative management of patients with brain tumours is a challenge for the neurosurgeon and the entire surgical team. The treating physician should consider factors such as the type of tumour, extent of disease, treatment received, the presence of comorbidities and prognosis of the disease itself. The successful execution of all aspects involved in perio perative management in patients with brain tumours will help prolong the life and improve the quality of life of patients.

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Prevention of Venous Thromboembolism in Neurosurgery

Cited by 163 publications

References 47 publications

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis

Vena cava filters are not superior to low molecular weight heparin in venous thromboembolism prophylaxis: a study on long term immobilized neurosurgical patients

Manejo perioperatorio de tumores intracraneales: rol del neurocirujano

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