gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Effect of different anticoagulation strategies on secondary hemorrhagic complications after external ventricular drainage placement in the treatment of cerebral aneurysms

Effekt unterschiedlicher Antikoagulationsstrategien auf sekundäre hämorrhagische Komplikationen nach Anlage externer Ventrikeldrainagen bei zerebralen Aneurysmen

Meeting Abstract

  • corresponding author M. Freytag - Abteilung für Neurochirurgie, Universitätsklinikum Hamburh-Eppendorf, Hamburg
  • T. Martens - Abteilung für Neurochirurgie, Universitätsklinikum Hamburh-Eppendorf, Hamburg
  • T. Ries - Abteilung für Neuroradiologie, Neurozentrum, Universitätsklinikum Hamburh-Eppendorf, Hamburg
  • M. Westphal - Abteilung für Neurochirurgie, Universitätsklinikum Hamburh-Eppendorf, Hamburg
  • P. Horn - Abteilung für Neurochirurgie, Universitätsklinikum Hamburh-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 063

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc318.shtml

Veröffentlicht: 11. April 2007

© 2007 Freytag et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To analyze the influence of different anticoagulation strategies on hemorrhagic complications due to placement/removal of external ventricular drainage (EVD) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: A total of 138 patients with aneurysms (56% (n=78) aSAH and 43% (n=60) incidental aneurysms) were treated during a one year period. 55 (40%) patients were treated by clipping followed by low-dose heparinization compared to 83 (60%) patients treated with coiling (periinterventional: 250 mg acetylsalicylic acid, ASA) followed by different anticoagulation strategies. Thirty-six patients (22 endovascular, 14 clipping) required EVD placement. Frequency and volume of intraparenchymal hemorrhage (IPH) due to EVD placement/removal was assessed by means of cCT.

Results: EVD placement/removal related hemorrhage was found in 7/36 (19%) of the patients. 27% of the coiled patients (n=6) that received EVD suffered from IPH, while IPH occurred in 7% (n=1) of the surgically treated cases with EVD. IPH volume ranged between 0,42cm3 to 28,9cm3 (mean±sd: 5,83cm3±10,3) for all patients, between 0,42cm3 to 4,32cm3 (mean±sd: 1,99cm3±1,73) in the endovascular group. In 4/6 patients treated interventionally IPH occurred after EVD removal. These patients received extended antithrombocytic medication after coiling as permanent medication.

Conclusions: Different anticoagulation strategies seem to have an effect on hemorrhagic complications of ventriculostomy. Placement, but also removing of EVD has to be considered as an operative act with hemorrhagic risk, especially due to extensive or prolonged anticoagulation after coiling.