Top

Published in:

01-06-2018 | Clinical Study

Risk of post-operative venous thromboembolism in patients with meningioma

Authors: Giorgio Carrabba, Marco Riva, Valeria Conte, Andrea Di Cristofori, Manuela Caroli, Marco Locatelli, Massimo Castellani, Paolo Bucciarelli, Andrea Artoni, Nino Stocchetti, Ida Martinelli, Paolo Rampini

Published in: Journal of Neuro-Oncology | Issue 2/2018

Abstract

The surgical resection of meningiomas can be complicated by venous thromboembolism (VTE) in the post-operative period, but the exact incidence of this event is not known. Aim of this study was to assess the occurrence of VTE in patients operated for meningioma who underwent a post-operative clinical and objective screening for VTE. Patients undergoing meningioma resection between 2000 and 2010 who accepted to be investigated for VTE in the post-operative period were included in the study. The screening included daily clinical assessment, pulmonary perfusion scintigraphy (Q-SCAN) on day 2 and venous compression ultrasonography (CUS) of the lower limbs within day 7. The univariate and multivariate statistical analysis of risk factors for VTE included sex, age, presence of comorbidities, pre- and post-operative Karnofsky Performance scale (KPS), post-operative neurological worsening and post-operative walking ability. Two-hundred and seventy-five patients were included in the study. VTE was diagnosed in 82 patients (29.8%). Univariate analysis revealed that age ≥ 65 years, cardiovascular comorbidities, pre- and post-operative KPS < 80/100, post-operative neurological worsening and impaired post-operative walking ability were significantly associated with VTE. Multivariate analysis confirmed only age ≥ 65 years (p = 0.011) and post-operative KPS < 80/100 (p = 0.002) as independent risk factors for VTE. Patients operated for meningioma have a 30% risk of VTE. Age ≥ 65 years and post-operative KPS < 80 were independent risk factors for VTE.

Dolecek TA, Propp JM, Stroup NE, Kruchko C (2012) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro-Oncology 14(Suppl 5):v1–49. https://doi.org/10.1093/neuonc/nos218 CrossRefPubMedPubMedCentral

Sawaya R, Glas-Greenwalt P (1992) Postoperative venous thromboembolism and brain tumors: part II. Hemostatic profile. J Neurooncol 14:127–134PubMed

Levi AD, Wallace MC, Bernstein M, Walters BC (1991) Venous thromboembolism after brain tumor surgery: a retrospective review. Neurosurgery 28:859–863CrossRefPubMed

Gerber DE, Segal JB, Salhotra A et al (2007) Venous thromboembolism occurs infrequently in meningioma patients receiving combined modality prophylaxis. Cancer 109:300–305. https://doi.org/10.1002/cncr.22405 CrossRefPubMed

Valladares JB, Hankinson J (1980) Incidence of lower extremity deep vein thrombosis in neurosurgical patients. Neurosurgery 6:138–141CrossRefPubMed

Hoefnagel D, Kwee LE, van Putten EHP et al (2014) The incidence of postoperative thromboembolic complications following surgical resection of intracranial meningioma. A retrospective study of a large single center patient cohort. Clin Neurol Neurosurg 123:150–154. https://doi.org/10.1016/j.clineuro.2014.06.001 CrossRefPubMed

Eisenring CV, Neidert MC, Sabanés Bové D et al (2013) Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients. PLoS ONE 8:e79170. https://doi.org/10.1371/journal.pone.0079170 CrossRefPubMedPubMedCentral

Safaee M, Sun MZ, Oh T et al (2014) Use of thrombin-based hemostatic matrix during meningioma resection: a potential risk factor for perioperative thromboembolic events. Clin Neurol Neurosurg 119:116–120. https://doi.org/10.1016/j.clineuro.2014.01.021 CrossRefPubMed

Swann KW, Black PM (1984) Deep vein thrombosis and pulmonary emboli in neurosurgical patients: a review. J Neurosurg 61:1055–1062. https://doi.org/10.3171/jns.1984.61.6.1055 CrossRefPubMed

10.

Cage TA, Lamborn KR, Ware ML et al (2009) Adjuvant enoxaparin therapy may decrease the incidence of postoperative thrombotic events though does not increase the incidence of postoperative intracranial hemorrhage in patients with meningiomas. J Neurooncol 93:151–156. https://doi.org/10.1007/s11060-009-9886-4 CrossRefPubMed

11.

Epstein NE (2005) A review of the risks and benefits of differing prophylaxis regimens for the treatment of deep venous thrombosis and pulmonary embolism in neurosurgery. Surg Neurol 64:295–301. https://doi.org/10.1016/j.surneu.2005.04.039. (discussion 302)CrossRefPubMed

12.

Mirzayan MJ, Calvelli K, Capelle H-H et al (2016) Subdural hematoma and oral anticoagulation: a therapeutic dilemma from the neurosurgical point of view. J Neurol Surg Part Cent Eur Neurosurg 77:31–35. https://doi.org/10.1055/s-0035-1558407

13.

Caroli M, Locatelli M, Prada F et al (2005) Surgery for intracranial meningiomas in the elderly: a clinical-radiological grading system as a predictor of outcome. J Neurosurg 102:290–294. https://doi.org/10.3171/jns.2005.102.2.0290 CrossRefPubMed

14.

Louis D, Ohgaki H, Wiestler O et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol (Berlin) 114:97–109. https://doi.org/10.1007/s00401-007-0243-4 CrossRef

15.

Sostman HD, Miniati M, Gottschalk A et al (2008) Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II. J Nucl Med 49:1741–1748. https://doi.org/10.2967/jnumed.108.052217 CrossRefPubMed

16.

Blom JW, Doggen CJM, Osanto S, Rosendaal FR (2005) Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 293:715–722. https://doi.org/10.1001/jama.293.6.715 CrossRefPubMed

17.

Hamilton MG, Hull RD, Pineo GF (1994) Venous thromboembolism in neurosurgery and neurology patients: a review. Neurosurgery 34:280–296. (discussion 296).CrossRefPubMed

18.

Crowther MA, Cook DJ, Griffith LE et al (2005) Deep venous thrombosis: clinically silent in the intensive care unit. J Crit Care 20:334–340. https://doi.org/10.1016/j.jcrc.2005.09.011 CrossRefPubMed

19.

Sacko O, Sesay M, Roux F-E et al (2007) Intracranial meningioma surgery in the ninth decade of life. Neurosurgery 61:950–955. https://doi.org/10.1227/01.neu.0000303190.80049.7d CrossRefPubMed

20.

Harris LM, Curl GR, Booth FV et al (1997) Screening for asymptomatic deep vein thrombosis in surgical intensive care patients. J Vasc Surg 26:764–769CrossRefPubMed

21.

Iorio A, Agnelli G (2000) Low-molecular-weight and unfractionated heparin for prevention of venous thromboembolism in neurosurgery: a meta-analysis. Arch Intern Med 160:2327. https://doi.org/10.1001/archinte.160.15.2327 CrossRefPubMed

22.

Browd SR, Ragel BT, Davis GE et al (2004) Prophylaxis for deep venous thrombosis in neurosurgery: a review of the literature. Neurosurg Focus 17:E1. https://doi.org/10.3171/foc.2004.17.4.1 CrossRefPubMed

Title: Risk of post-operative venous thromboembolism in patients with meningioma
Authors: Giorgio Carrabba
Marco Riva
Valeria Conte
Andrea Di Cristofori
Manuela Caroli
Marco Locatelli
Massimo Castellani
Paolo Bucciarelli
Andrea Artoni
Nino Stocchetti
Ida Martinelli
Paolo Rampini
Publication date: 01-06-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2810-z

ACC 2024 Congress

Springer Medicine

Risk of post-operative venous thromboembolism in patients with meningioma

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2018

Cost-effectiveness of the long-term use of temozolomide for treating newly diagnosed glioblastoma in Germany

Brain metastasis in gastroesophageal adenocarcinoma and HER2 status

Prognostic role of high sensitivity C-reactive protein and interleukin-6 in glioma and meningioma patients

Long-term hearing outcomes after gamma knife surgery in patients with vestibular schwannoma with hearing preservation: evaluation in 92 patients with serial audiograms

Debulking surgery of pituitary adenoma as a strategy to facilitate definitive stereotactic radiosurgery

Anti-differentiation non-coding RNA, ANCR, is differentially expressed in different types of brain tumors