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

Venous thromboembolic events are more frequent in high grade then in low grade glioma patients

Thrombembolische Ereignisse treten häufiger in hochgradigen als in niedriggradigen Gliomen auf

Meeting Abstract

  • corresponding author Á. Oszvald - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • R. Gerlach - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • K. Franz - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main

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. DocSO.03.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc222.shtml

Published: April 11, 2007

© 2007 Oszvald et al.
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Outline

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Objective: To review the incidence of venous thromboembolic (TE) events in cerebral glioma patients.

Methods: The data for this study derive from a large prospectively conducted data base of cerebral gliomas with regular follow-up from diagnosis to death. 75 patients (male:femal; 40:35) initially diagnosed with cerebral glioma from October 2005 through October 2006 were included. All patients underwent either microsurgical removal or biopsy. 47 patients (median 67y) with WHO °IV, 12 patients (median 45.5y) with WHO °III, 13 patients (median 40y) with WHO °II and 3 patients (median 45y) with WHO °I gliomas were treated during this year. Venous thromboembolism (TE) prophylaxis was performed with antithromboembolism (AT) stockings and Nadroparin sc 0.3 ml/d from day 1 postoperative until discharge. Clinically minor or unspecific symptoms (diffuse lower leg pain, slight fever and general condition worsening) led to analysis of D-Dimere (parameter of activated coagulation). Thrombosis (DVT) and/or pulmonary artery embolism (PE) was suspected in case of a rise of D-Dimere and had been verified by Duplex Sonography and CT thorax or autopsy.

Results: 11 of 47 patients (23%) with a WHO°IV glioma and 4 of 12 patients with a WHO°III glioma (33.3%) developed a DVT or PE. Among the 16 patients with low grade gliomas no DVT or PE was observed. 36% of the WHO°IV and 100% of the WHO°III patients with TE events developed them during the perioperative period, whereas 64% (7/11) of the WHO°IV patients developed TE events during the course of disease.

Conclusions: In high grade gliomas the occurrence of DVT or PE ranges between 23% and 33%, compared to none in low grade gliomas. Although a rigorous prophylaxis (AT-stockings and nadroparin) has been consequently performed, a surprisingly high number of TE events have been observed. Since apparative diagnostic screening procedures are not performed routinely, a more attentive clinical observation should discover unspecific symptoms and lead to immediate diagnostic procedure. With regard to our results TE prophylaxis during the course of disease needs to be discussed.