Neurosurgery. 27(1):74–77, JULY 1990
Issn Print: 0148-396X
Publication Date: July 1990
The Risk and Efficacy of Anticoagulant Therapy in the Treatment of Thromboembolic Complications in Patients with Primary Malignant Brain Tumors
Eric Altschuler;Hans Moosa;Robert Selker;Frank Vertosick;
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Departments of Neurological Surgery (E.A. RGS, FTV) and General Surgery (HM), University of Pittsburgh School of Medicine and The Montefiore Hospital, Pittsburgh, Pennsylvania
Abstract
Twenty-three patients with malignant glial neoplasms were treated with anticoagulant therapy for thromboembolic complications. Fifteen patients had deep vein thrombosis alone, and 8 patients had both deep vein thrombosis and pulmonary embolism. Serum prothrombin times were maintained at 1.25 times control for an average of 5.8 months per patient, for a total patient exposure to warfarin therapy of 132 patient-months (11 patient-years). Only 1 patient suffered a recurrent pulmonary embolism, and this occurred during an episode of gastrointestinal bleeding, when anticoagulant therapy had to be discontinued prematurely. All patients were followed with serial computed tomographic or magnetic resonance imaging scans, and no patient showed radiographic evidence of intratumoral hemorrhage either during or after warfarin therapy. One patient, who died from a large recurrent glioblastoma, was found at autopsy to have scattered foci of intratumoral hemorrhage. This series, together with a review of the available literature, suggests that oral anticoagulant therapy is both a safe and effective means of treating thromboembolic complications in patients with residual malignant glial tumors. (Neurosurgery 27:74-77, 1990)
