Use of antithrombotic agents in patients with intracerebral cavernous malformations: Clinical article

Kelly Flemming, Michael J. Link, Teresa J H Christianson, Robert D Jr. Brown

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Object. The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs). Methods. From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage. Results. The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5%) of the 40 patients initially presented with hemorrhage and 4 (10%) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41% per person-year). Conclusions. Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.

Original languageEnglish (US)
Pages (from-to)43-46
Number of pages4
JournalJournal of Neurosurgery
Volume118
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Fibrinolytic Agents
Hemorrhage
Platelet Aggregation Inhibitors
Natural History
Anticoagulants

Keywords

  • Anticoagulation
  • Antithrombotic agent
  • Aspirin
  • Cavernous malformation
  • Hemorrhage
  • Vascular disorders

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Use of antithrombotic agents in patients with intracerebral cavernous malformations : Clinical article. / Flemming, Kelly; Link, Michael J.; Christianson, Teresa J H; Brown, Robert D Jr.

In: Journal of Neurosurgery, Vol. 118, No. 1, 01.2013, p. 43-46.

Research output: Contribution to journalArticle

@article{54cba11ab1e74bd2be681d789d6ffa37,
title = "Use of antithrombotic agents in patients with intracerebral cavernous malformations: Clinical article",
abstract = "Object. The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs). Methods. From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage. Results. The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5{\%}) of the 40 patients initially presented with hemorrhage and 4 (10{\%}) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41{\%} per person-year). Conclusions. Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.",
keywords = "Anticoagulation, Antithrombotic agent, Aspirin, Cavernous malformation, Hemorrhage, Vascular disorders",
author = "Kelly Flemming and Link, {Michael J.} and Christianson, {Teresa J H} and Brown, {Robert D Jr.}",
year = "2013",
month = "1",
doi = "10.3171/2012.8.JNS112050",
language = "English (US)",
volume = "118",
pages = "43--46",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "1",

}

TY - JOUR

T1 - Use of antithrombotic agents in patients with intracerebral cavernous malformations

T2 - Clinical article

AU - Flemming, Kelly

AU - Link, Michael J.

AU - Christianson, Teresa J H

AU - Brown, Robert D Jr.

PY - 2013/1

Y1 - 2013/1

N2 - Object. The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs). Methods. From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage. Results. The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5%) of the 40 patients initially presented with hemorrhage and 4 (10%) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41% per person-year). Conclusions. Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.

AB - Object. The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs). Methods. From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage. Results. The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5%) of the 40 patients initially presented with hemorrhage and 4 (10%) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41% per person-year). Conclusions. Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.

KW - Anticoagulation

KW - Antithrombotic agent

KW - Aspirin

KW - Cavernous malformation

KW - Hemorrhage

KW - Vascular disorders

UR - http://www.scopus.com/inward/record.url?scp=84872175957&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872175957&partnerID=8YFLogxK

U2 - 10.3171/2012.8.JNS112050

DO - 10.3171/2012.8.JNS112050

M3 - Article

C2 - 22998055

AN - SCOPUS:84872175957

VL - 118

SP - 43

EP - 46

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 1

ER -