Anticoagulation Therapy for Prevention of Acute Pulmonary Thromboembolism in Patients with Intracerebral Hemorrhage in Acute Phase

No shinkei geka. Neurological surgery
Yuya KatoTeiji Tominaga

Abstract

Pulmonary thromboembolism(PTE)can be a lethal complication in patients with intracerebral hemorrhage(ICH), and the early detection of deep venous thrombosis(DVT)is important for prevention of PTE. Anticoagulation therapy is effective for prevention of PTE; however, in ICH patients, the safety of anticoagulants is not established because of concern about ICH expansion. We investigated the clinical data of patients who developed ICH and assessed risk factors for DVT and the safety of anticoagulation therapy. Our study included 250 patients between 2014 and 2016. We performed weekly screening of D-dimer and ultrasonography of lower limb veins was performed when levels gradually increased or reached 10 μg/mL. In patients with DVT, we started anticoagulation therapy after systolic blood pressures were controlled at ≤140 mmHg. DVT was detected in 35(14.0%)patients, and 29(11.6%)underwent anticoagulation therapy. A hemorrhagic complication was observed in 1 case as gastrointestinal bleeding. Expansion of ICH was not detected in any cases. Symptomatic PTE occurred in 1 case with DVT, just before initiation of anticoagulants. Univariate logistic regression analysis revealed hemorrhage volume ≥30 mL and modified Rankin Scale score ≥5 at ...Continue Reading

Citations

Sep 24, 2021·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·A I KhripunE A Luk'yanova

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