Venous Thromboembolism in Neurosurgery and Neurology Patients

Hamilton, Mark G.; Hull, Russell D.; Pineo, Graham F.

doi:10.1097/00006123-199402000-00012

Cited by 80 publications

(83 citation statements)

References 130 publications

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“…Previous work suggesting increased platelet adhesiveness in malignant brain tumors is consistent with this supposition [14,16]. More recent work by Iberti et al (1994) [17] supports the concept of an increased coagulable state of brain tumor patients [17,18].…”

Section: Discussionsupporting

confidence: 64%

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Effect of dalteparin and radiation on survival and thromboembolic events in glioblastoma multiforme: a phase II ECOG trial

Robins

O’Neill

Gilbert

et al. 2007

Cancer Chemother Pharmacol

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Laboratory and clinical studies support the concept that heparins, particularly the low molecular component, may serve as an inhibitor of angiogenesis, providing anti-neoplastic effects. Further, treatment with low molecular weight heparin (LMWH) may provide prophylaxis for thromboembolic events (TEE), in glioblastoma (GBM) patients. Dalteparin (5000 u sub Q daily) was given with and after conventional radiotherapy to newly diagnosed GBM patients. Forty-five patients were accrued between 5/02 and 9/04; 3 were ineligible. At time of progression, patients could continue dalteparin in addition to standard regimens. Pretreatment characteristics included: Median age 61 (range 26-78); ECOG Performance status: 0=38%, 1=57%, 2=5%; gross total resection 45%. There were no grade 3/4 bleeding or thrombocytopenic events, and no TEE occurred while on dalteparin. Median time on dalteparin was 6.3 months, median time to progression was 3.9 months; median survival was 11.9 months. There was no significant improvement in survival when compared to the RTOG GBM database (with various radiation/drug doublets including BCNU) using recursive partitioning analysis. Historically the incidence of TEE in GBM patients is ∼30%. As this study suggests dalteparin reduces the incidence of TEE, and does not have significant overlapping toxicities with most other drugs, its testing in a combined modality approach with other medications may be warranted in future trials.

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Section: Discussionsupporting

confidence: 64%

“…Additionally, there was recognized at the onset of clinical trial design that patients with GBM were highly predisposed to thromboembolic phenomena [10][11][12][13][14][15][16][17][18][19][20]. Thus, it was further hypothesized that the administration of dalteparin, a LMWH, might provide prophylaxis for TEE.…”

Section: Introductionmentioning

confidence: 99%

Effect of dalteparin and radiation on survival and thromboembolic events in glioblastoma multiforme: a phase II ECOG trial

Robins

O’Neill

Gilbert

et al. 2007

Cancer Chemother Pharmacol

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“…Although VTE is relatively common in the general population, it is far more common during the post-operative period [25,27,[39][40][41][42][51][52][53]. Proposed explanations for this phenomenon include limited post-operative mobility, which can promote venous stasis, and damage to endothelial tissue, as discussed above.…”

Section: Vte In Brain Tumor Patientsmentioning

confidence: 99%

“…For DVT, upper/lower extremity ultrasound is often sufficient to locate and image the embolus [42,72]. In the case of PE, more common radiographic techniques include chest CT scans and V/Q scans [14,26,31,71].…”

Section: Presenting Signs and Symptomsmentioning

confidence: 99%

“…Studies have shown that other risk factors for VTE include age, sex, ethnicity, blood type, length of hospital stay, operative duration, and coagulation status [3,6,[8][9][10]14,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Standard prophylactic measures for VTE include chemical anticoagulation, mechanical prophylaxis, and increased ambulation during the post-operative period [36,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. This paper seeks to review the relevant and current literature on VTE in brain tumor patients, with particular focus on the risk factors and presenting symptoms of VTE, treatment options for those with VTE, and a review of current prophylactic measures for VTE.…”

Section: Introductionmentioning

confidence: 99%

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Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

Coté¹,

Smith

2015

J Hematol Thrombo Dis

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Venous thromboembolism (VTE) is a relatively common and well-described condition, affecting approximately 1-2% of the general population. VTE can lead to significant morbidity and death via pulmonary embolism (PE). During the post-operative period, VTE occurs at higher rates due to natural thrombotic responses to injury and limited post-operative mobility. In general, rates of post-operative VTE are higher in patients undergoing operations for cranial and spinal lesions than for lesions of other types, a phenomenon that is not fully explained. Several studies have demonstrated that other risk factors for VTE include age, sex, ethnicity, hospital stay length, and coagulation state. Aggressive chemical and mechanical measures for VTE prophylaxis are indicated in the postoperative period to prevent the formation of VTE. Here we review the literature on VTE in brain tumor patients, with a focus on their etiology, diagnosis, treatment, and prophylaxis.

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