TY - JOUR
T1 - Pharmacological prophylaxis of venous thromboembolism during acute phase of spontaneous intracerebral hemorrhage
T2 - What do we know about risks and benefits?
AU - Masotti, Luca
AU - Godoy, Daniel Agustin
AU - Napoli, Mario Di
AU - Rabinstein, Alejandro A.
AU - Paciaroni, Maurizio
AU - Ageno, Walter
PY - 2012/7
Y1 - 2012/7
N2 - Spontaneous intracerebral hemorrhage (sICH) represents a devastating clinical event with high mortality and morbidity rates. Only few patients with sICH are treated with neurosurgical evacuation of the hematoma, and the majority of them need only a good conservative medical approach. The goal of medical treatment is to avoid secondary neurological and systemic complications. Venous thromboembolism (VTE) represents one of the most feared complications of sICH, and it is a potential cause of death. The balance between the benefit of VTE prevention and the risk of hematoma enlargement and/or rebleeding with the use of pharmacologic thromboprophylaxis remains controversial because of the lack of consistent evidences in the literature. The efficacy of mechanical prophylaxis is also uncertain. Consequently, until now there are no clear guidelines and scientific evidences available for physicians in this field. The aim of this review is to analyze the available literature and guidelines about pharmacological VTE prophylaxis in patients with nonsurgical sICH.
AB - Spontaneous intracerebral hemorrhage (sICH) represents a devastating clinical event with high mortality and morbidity rates. Only few patients with sICH are treated with neurosurgical evacuation of the hematoma, and the majority of them need only a good conservative medical approach. The goal of medical treatment is to avoid secondary neurological and systemic complications. Venous thromboembolism (VTE) represents one of the most feared complications of sICH, and it is a potential cause of death. The balance between the benefit of VTE prevention and the risk of hematoma enlargement and/or rebleeding with the use of pharmacologic thromboprophylaxis remains controversial because of the lack of consistent evidences in the literature. The efficacy of mechanical prophylaxis is also uncertain. Consequently, until now there are no clear guidelines and scientific evidences available for physicians in this field. The aim of this review is to analyze the available literature and guidelines about pharmacological VTE prophylaxis in patients with nonsurgical sICH.
KW - deep vein thrombosis
KW - intracerebral hemorrhage
KW - low molecular weight heparin
KW - prophylaxis
KW - pulmonary embolism
KW - therapy
KW - unfractioned heparin
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U2 - 10.1177/1076029612441055
DO - 10.1177/1076029612441055
M3 - Review article
C2 - 22609819
AN - SCOPUS:84863445958
SN - 1076-0296
VL - 18
SP - 393
EP - 402
JO - Clinical and Applied Thrombosis/Hemostasis
JF - Clinical and Applied Thrombosis/Hemostasis
IS - 4
ER -