Duplex Ultrasound Screening for Deep Venous Thrombosis in Patients Undergoing Craniotomy for Intracranial Tumors: A Single Institutional Series

Abstract

Objective: The frequency of duplex ultrasound screening (DUS) for deep vein thrombosis (DVT) in patients with brain tumors undergoing craniotomy is center-specific. We evaluated clinical conditions that increase the tendency to perform DUS, focusing on tumor type. Methods: This is a single-center retrospective analysis to assess the association of intracranial tumor type with DVT as a major decision-making indicator for DUS. A primary analysis investigated the association between tumor pathology and preoperative DVT, and a secondary analysis investigated the development of DVT postoperatively. Confounding factors were defined and included in both analyses. Results: Among 1478 patients, 751 had preoperative DUS and 35 (5%) had DVT. No significant difference in the odds of preoperative DVT was observed between patients having malignant glioma versus benign tumors (odds ratio [OR; 95% CI]: 1.68 [0.65, 4.35], P = 0.29), or metastatic tumors versus benign tumors (OR: 2.10; 95% CI: 0.75-5.89; P = 0.16). Among patients with negative preoperative DUS, 93 underwent postoperative evaluation and 20 (22%) were diagnosed with postoperative DVT. Malignant glioma or (OR: 1.69; 95% CI: 0.36-7.84; P = 0.50) metastatic tumors (OR: 1.84; 95% CI: 0.29-11.5; P = 0.52) were not associated with postoperative DVT versus benign tumors. Conclusion: Brain tumor pathology may not increase the risk for DVT and may not be a good indicator for the selection of patients for DVT screening with DUS. The incidence of DVT in selective preoperative DUS was similar to studies that performed DUS on all patients. Further studies across multiple institutions are needed to develop criteria for DUS in brain tumor surgery.