Venous thromboembolism in neurologic disease

Schneck, Michael

doi:10.1016/b978-0-7020-4086-3.00020-5

Cited by 6 publications

(2 citation statements)

References 109 publications

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“…Overall, its mechanism of action does not seem to be limited to hemodynamic modifications. These facts raise the possibility that neural factor is of immense importance in thrombus pathogenesis (Schneck 2014 ). All pieces put together may lead to a possible conclusion, a hypothesis presented below.…”

Section: In Summarymentioning

confidence: 99%

Electrical muscle stimulation in thomboprophylaxis: review and a derived hypothesis about thrombogenesis—the 4th factor

Stefanou

2016

SpringerPlus

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IntroductionElectrical muscle stimulation (EMS) is an FDA-approved thromboprophylactic method. Thrombus pathogenesis is considered to depend on factors related to components of the vessel wall, the velocity of blood, and blood consistency—collectively known as, the Virchow’s triad.ObjectiveThe testimony supporting the thromboprophylactic effects of the EMS is reviewed. An emphasis is placed on the fact that, EMS has demonstrated, in certain circumstances, an efficacy rate that cannot be fully explained by the Virchow’s triad; also that, in reviewing relevant evidence and the theorized pathophysiological mechanisms, several findings collectively point to a potentially missed point. Remarkably, venous thromboembolic disease (VTE) is extremely more common in the lower versus the upper extremities even when the blood velocities equalize; EMS had synergistic effects with intermittent compressive devices, despite their presumed identical mechanism of action; sleep is not thrombogenic; non-peroperative EMS is meaningful only if applied ≥5 times daily; neural insult increases VTEs more than the degree expected by the hypomobility-related blood stasis; etc. These phenomena infer the presence of a 4th thrombogenetic factor: neural supply to the veins provides direct antithrombic effects, by inducing periodic vessel diameter changes and/or by neuro-humoral, chemically acting factors. EMS may stimulate or substitute the 4th factor. This evidence-based hypothesis is analyzed.ConclusionA novel pathophysiologic mechanism of thrombogenesis is supported; and, based on this, the role of EMS in thromboprophylaxis is expanded. Exploration of this mechanism may provide new targets for intervention.

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Section: In Summarymentioning

confidence: 99%

Electrical muscle stimulation in thomboprophylaxis: review and a derived hypothesis about thrombogenesis—the 4th factor

Stefanou

2016

SpringerPlus

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“…Multiple case reports and series on postoperative thromboembolic prophylaxis have been published, however clear guidelines for a "Best Practice" have yet to be described [6][7][8]. Many investigators and even whole institutions have taken to stratifying the risk for developing VTE and treating the calculated risk accordingly.…”

Section: Introductionmentioning

confidence: 99%

Bleeding Risk and Thromboprophylaxis in Neurosurgical Patients after Emergency Procedure

Cagliani¹,

Ritter²,

Nelson³

et al. 2017

Intensive & Crit Care

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Purpose: We aimed to evaluate its safety in the emergency neurosurgical population at a tertiary hospital center. Methods:Retrospective analyses of prospectively-collected data were performed on patients ad-mitted to the surgical intensive care unit (SICU) after emergency neurosurgical procedure. We examined patient demographic and clinical information, survival outcomes, and rates of heparin induced thrombocytopenia and pulmonary embolism in patients who received subcutaneous unfractionated heparin (SCUFH) compared to those who did not. Results: We identified 223 emergency neurosurgical patients, of which 100 received no anticoagulation (44.84%) and 123 received SCUFH (55.16%). In the SCUFH group, 88 patients received chemoprophylaxis within 24 h and 35 after 24 h. A statistically significant difference was noted with the admission APACHE II score of patients receiving SCUFH to those who did not, but APACHE III and SAPS on admission were shown to have no difference in outcome. Conclusion:Administration of SCUFH in the emergency neurosurgical population does not increase the risk of bleeding post-operatively and continues to be a safe and effective chemoprophylaxis agent against VTE.

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Venous Thromboembolism Prophylaxis in Neurosurgery

Prabhu

2016

Anticoagulation and Hemostasis in Neurosurgery

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Venous thromboembolism in neurologic disease

Cited by 6 publications

References 109 publications

Electrical muscle stimulation in thomboprophylaxis: review and a derived hypothesis about thrombogenesis—the 4th factor

Electrical muscle stimulation in thomboprophylaxis: review and a derived hypothesis about thrombogenesis—the 4th factor

Bleeding Risk and Thromboprophylaxis in Neurosurgical Patients after Emergency Procedure

Venous Thromboembolism Prophylaxis in Neurosurgery

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