• Medientyp: E-Artikel
  • Titel: Direct oral anticoagulants vs. low-molecular-weight heparin for pulmonary embolism in patients with glioblastoma
  • Beteiligte: Dubinski, Daniel; Won, Sae-Yeon; Voss, Martin; Keil, Fee; Miesbach, Wolfgang; Behmanesh, Bedjan; Dosch, Max; Baumgarten, Peter; Bernstock, Joshua D.; Seifert, Volker; Freiman, Thomas M.; Gessler, Florian
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: Neurosurgical Review
  • Sprache: Englisch
  • DOI: 10.1007/s10143-021-01539-9
  • ISSN: 0344-5607; 1437-2320
  • Schlagwörter: Neurology (clinical) ; General Medicine ; Surgery
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:p>Glioblastoma (GBM) is a cancer type with high thrombogenic potential and GBM patients are therefore at a particularly high risk for thrombotic events. To date, only limited data on anticoagulation management after pulmonary embolism (PE) in GBM is available and the sporadic use of DOACs remains off-label. A retrospective cohort analysis of patients with GBM and postoperative, thoracic CT scan confirmed PE was performed. Clinical course, follow-up at 6 and 12 months and the overall survival (OS) were evaluated using medical charts and neuroradiological data. Out of 584 GBM patients, 8% suffered from postoperative PE. Out of these, 30% received direct oral anticoagulants (DOACs) and 70% low-molecular-weight heparin (LMWH) for therapeutic anticoagulation. There was no significant difference in major intracranial hemorrhage (ICH), re-thrombosis, or re-embolism between the two cohorts. Although statistically non-significant, a tendency to reduced mRS at 6 and 12 months was observed in the LMWH cohort. Furthermore, patients receiving DOACs had a statistical benefit in OS. In our analysis, DOACs showed a satisfactory safety profile in terms of major ICH, re-thrombosis, and re-embolism compared to LMWH in GBM patients with postoperative PE. Prospective, randomized trials are urgent to evaluate DOACs for therapeutic anticoagulation in GBM patients with PE.</jats:p>