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Pryamikov A.D.
Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital
Mironkov A.B.
Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital
Asratyan S.A.
Buyanov City Clinical Hospital
Suryakhin V.S.
Buyanov City Clinical Hospital
Belkov M.V.
Buyanov Moscow City Clinical Hospital
Venous thromboembolic complications in patients with subarachnoid hemorrhage following cerebral aneurysm rupture
Journal: Journal of Venous Disorders. 2022;16(4): 289‑295
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To cite this article:
Khripun AI, Pryamikov AD, Mironkov AB, Asratyan SA, Suryakhin VS, Alimov AN, Belkov MV. Venous thromboembolic complications in patients with subarachnoid hemorrhage following cerebral aneurysm rupture. Journal of Venous Disorders.
2022;16(4):289‑295. (In Russ.)
https://doi.org/10.17116/flebo202216041289
To analyze the incidence of in-hospital venous thromboembolic complications (VTEC) in patients with ruptured brain aneurysms followed by non-traumatic subarachnoid hemorrhage (SAH) and to evaluate the outcomes of anticoagulation for prevention and treatment of VTEC.
A single-center cohort retrospective study enrolled 36 patients with non-traumatic SAH following cerebral aneurysm rupture. We analyzed diagnosis, prevention and treatment of VTEC between January 2020 and March 2022. Drug prevention of VTEC was carried out by low molecular weight heparins (LMWH). LMWH were prescribed depending on severity of hemorrhage, blood clotting test data and indications for surgery. Anticoagulants were prescribed as early as possible after intracranial hemorrhage (within 24 hours) or surgery (within 1—2 days). In case of venous thrombosis, we prescribed LMWH in therapeutic dosages.
Seven (19%) patients had venous thrombosis at admission. Therapeutic doses of LMWH were prescribed in 6 patients. One patient required implantation of cava filter in 2 days after embolization of cerebral aneurysm due to bilateral severe pulmonary embolism (PE). Mortality in these patients was 71.4%. Twenty-three (64%) patients received preventive anticoagulation. Of these, deep vein thrombosis developed in 13 (57%) patients, moderate pulmonary embolism — in 2 patients. In this group, 9 (39%) patients died. There were no major hemorrhagic complications associated with anticoagulation.
Incidence of VTEC is high in patients with non-traumatic SAH that requires target searching for venous thrombosis and preventive LMWH therapy.
Authors:
Pryamikov A.D.
Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital
Mironkov A.B.
Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital
Asratyan S.A.
Buyanov City Clinical Hospital
Suryakhin V.S.
Buyanov City Clinical Hospital
Belkov M.V.
Buyanov Moscow City Clinical Hospital
Received:
30.05.2022
Accepted:
21.09.2022
List of references:
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