TY  - JOUR
A1  - Dubinski, Daniel
A1  - Won, Sae-Yeon
A1  - Voß, Martin
A1  - Keil, Fee
A1  - Miesbach, Wolfgang
A1  - Behmanesh, Bedjan
A1  - Dosch, Max
A1  - Baumgarten, Peter
A1  - Bernstock, Joshua D.
A1  - Seifert, Volker
A1  - Freiman, Thomas Michael
A1  - Geßler, Florian
T1  - Direct oral anticoagulants vs. low-molecular-weight heparin for pulmonary embolism in patients with glioblastoma
T2  - Neurosurgical review
N2  - 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.
KW  - Pulmonary embolism
KW  - Direct oral anticoagulation
KW  - Low-molecular-weight heparin
KW  - Therapeutic anticoagulation
KW  - Glioblastoma survival
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63633
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-636336
SN  - 1437-2320
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 45
IS  - 1
SP  - 451
EP  - 457
PB  - Springer
CY  - Berlin ; Heidelberg ; New York
ER  -