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Results of early administration of low molecular weight heparin for prevention of venous thromboembolism after removal of brain tumors

https://doi.org/10.17650/1683-3295-2021-23-3-30-38

Abstract

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.

About the Authors

A. V. Bervitskiy
Federal Neurosurgical Center, Ministry of Health of Russia; Research Institute of Clinical and Experimental Lymрhology – branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences; Lavrentyev Institute of Hydrodynamics, Siberian Branch of Russian Academy of Sciences
Russian Federation

Anatoly V. Bervitsky

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087,

2 Timakova St., Novosibirsk 630117,

15 Academika Lavrentyeva Ave., Novosibirsk 630090



V. E. Guzhin
Federal Neurosurgical Center, Ministry of Health of Russia
Russian Federation

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087



G. I. Moisak
Federal Neurosurgical Center, Ministry of Health of Russia; Novosibirsk State University
Russian Federation

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087,

1 Pirogova St., Novosibirsk 630090



E. Z. Imamurzaev
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

Bld. 1, 20 Delegatskaya St., Moscow 127473



E. V. Amelina
Novosibirsk State University
Russian Federation

1 Pirogova St., Novosibirsk 630090



A. V. Kalinovsky
Federal Neurosurgical Center, Ministry of Health of Russia
Russian Federation

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087



D. A. Rzayev
Federal Neurosurgical Center, Ministry of Health of Russia; Novosibirsk State University
Russian Federation

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087,

1 Pirogova St., Novosibirsk 630090



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For citations:


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. Russian journal of neurosurgery. 2021;23(3):30-38. (In Russ.) https://doi.org/10.17650/1683-3295-2021-23-3-30-38

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ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
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