Results of early administration of low molecular weight heparin for prevention of venous thromboembolism after removal of brain tumors [Результаты раннего назначения низкомолекулярного гепарина с целью профилактики венозных тромбоэмболических осложнений после удаления опухолей головного мозга]

Results of early administration of low molecular weight heparin for prevention of venous thromboembolism after removal of brain tumors [Результаты раннего назначения низкомолекулярного гепарина с целью профилактики венозных тромбоэмболических осложнений после удаления опухолей головного мозга] Full article

Journal

Russian Journal of Neurosurgery
ISSN: 1683-3295

Output data

Year: 2021, Volume: 23, Number: 3, Pages: 30-38 Pages count : 9 DOI: 10.17650/1683-3295-2021-23-3-30-38

Tags

Brain tumor; Intracranial hemorrhage; Low molecular weight heparin; Venous thromboembolic complications

Authors

Bervitskiy A.V. ^1,2,3 , Guzhin V.E. ¹ , Moisak G.I. ^1,4 , Imamurzaev E.Z. ⁵ , Amelina E.V. ⁴ , Kalinovsky A.V. ¹ , Rzayev D.A. ^1,4

Affiliations

1	Federal Neurosurgical Center, Ministry of Health of Russia, 132 / 1 Nemirovicha-Danchenko St., Novosibirsk, 630087, Russian Federation
2	Res. Inst. of Clinical and Experimental Lymhology - Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 2 Timakova St., Novosibirsk, 630117, Russian Federation
3	Siberian Branch of Russian Academy of Sciences, Lavrentyev Institute of Hydrodynamics, 15 Academika Lavrentyeva Ave., Novosibirsk, 630090, Russian Federation
4	Novosibirsk State University, 1 Pirogova St., Novosibirsk, 630090, Russian Federation
5	A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Bld. 1, 20 Delegatskaya St., Moscow, 127473, Russian Federation

Introduction. Patients with brain tumors are at increased risk for the development of venous thromboembolism (VTE). The most effective prevention method today is a combination of mechanical compression of the lower extremities and the introduction of low molecular weight heparin (LMWH). In 2018, an algorithm for the prevention of VTE was introduced in our clinic, which implies the early (in the first 48 h after surgery) administration of LMWH. The study objective is to assess the effect of early LMWH administration on the incidence of intracranial hemorrhage (ICH) after removal of brain tumors. Materials and methods. From January 2014 to December 2019, 3266 patients underwent removal of brain tumors. The group 1 included 2057 patients who were treated in the period before the introduction of the VTE prevention algorithm (2014- 2017), the group 2 included 1209 patients who were treated using this algorithm (2018-2019). In each of the groups, the frequency and timing of ICH were assessed. The severity of complications was assessed according to the F. A.L. Ibanez classification. The data were compared between groups 1 and 2, as well as between patients who received LMWH at the time of ICH and those who did not receive. Results. Patients of the group 1 were prescribed LMWH in 14.3 % of cases, on average on the 4th day after surgery. In this group, 26 (1.26 %) patients developed ICH. Patients of the group 2 were prescribed LMWH in 89 % of cases, on average on the 2nd day. In this group, 15 (1.24 %) patients developed ICH. Severe complications were in 6 (85.7 %) of 7 patients who received LMWH at the time of ICH, and in 25 (73.5 %) of 34 patients who did not receive LMWH (p = 0.66). Conclusion. The widespread use of LMWH for the prevention of VTE during the first 48 h after removal of brain tumors did not lead to an increase in the frequency of ICH. At the same time, patients with ICH who developed during the use of LMWH often had a more severe clinical course. © 2021 Russian Journal of Neurosurgery. All rights reserved.

Bervitskiy A.V. , Guzhin V.E. , Moisak G.I. , Imamurzaev E.Z. , Amelina E.V. , Kalinovsky A.V. , Rzayev D.A.
Results of early administration of low molecular weight heparin for prevention of venous thromboembolism after removal of brain tumors [Результаты раннего назначения низкомолекулярного гепарина с целью профилактики венозных тромбоэмболических осложнений после удаления опухолей головного мозга]
Russian Journal of Neurosurgery. 2021. V.23. N3. P.30-38. DOI: 10.17650/1683-3295-2021-23-3-30-38 Scopus РИНЦ OpenAlex

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