PMID- 28890040
OWN - NLM
STAT- MEDLINE
DCOM- 20180511
LR  - 20220409
IS  - 1532-2653 (Electronic)
IS  - 0967-5868 (Linking)
VI  - 45
DP  - 2017 Nov
TI  - Risk of Deep vein thrombosis in neurosurgery: State of the art on prophylaxis 
      protocols and best clinical practices.
PG  - 60-66
LID - S0967-5868(17)30958-X [pii]
LID - 10.1016/j.jocn.2017.08.008 [doi]
AB  - OBJECTIVE: To analytically discuss some protocols in Deep vein thrombosis 
      (DVT)/pulmonary Embolism (PE) prophylaxis currently use in Neurosurgical 
      Departments around the world. DATA SOURCES: Analysis of the prophylaxis protocols 
      in the English literature: An analytical and narrative review of literature 
      concerning DVT prophylaxis protocols in Neurosurgery have been conducted by a 
      PubMed search (back to 1978). DATA EXTRACTION: 80 abstracts were reviewed, and 74 
      articles were extracted. DATA ANALYSIS: The majority of DVT seems to develop 
      within the first week after a neurosurgical procedure, and a linear correlation 
      between the duration of surgery and DVT occurrence has been highlighted. The 
      incidence of DVT seems greater for cranial (7.7%) than spinal procedures (1.5%). 
      Although intermittent pneumatic compression (IPC) devices provided adequate 
      reduction of DVT/PE in some cranial and combined cranial/spinal series, low-dose 
      subcutaneous unfractionated heparin (UFH) or low molecular-weight heparin (LMWH) 
      further reduced the incidence, not always of DVT, but of PE. Nevertheless, 
      low-dose heparin-based prophylaxis in cranial and spinal series risks minor and 
      major postoperative haemorrhages: 2-4% in cranial series, 3.4% minor and 3.4% 
      major haemorrhages in combined cranial/spinal series, and a 0.7% incidence of 
      major/minor haemorrhages in spinal series. CONCLUSION: This analysis showed that 
      currently most of the articles are represented by case series and case reports. 
      As long as clear guidelines will not be defined and universally applied to this 
      diverse group of patients, any prophylaxis for DVT and PE should be tailored to 
      the individual patient with cautious assessment of benefits versus risks.
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Ganau, Mario
AU  - Ganau M
AD  - Harvard Medical School, Harvard University, Boston, MA, USA.
FAU - Prisco, Lara
AU  - Prisco L
AD  - Nuffield Department of Clinical Neuroscience, Oxford University Hospitals, UK.
FAU - Cebula, Helene
AU  - Cebula H
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France.
FAU - Todeschi, Julien
AU  - Todeschi J
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France. Electronic address: 
      julien.tod@gmail.com.
FAU - Abid, Houssem
AU  - Abid H
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France.
FAU - Ligarotti, Gianfranco
AU  - Ligarotti G
AD  - Instituto Neurologico Besta, Milano, Italy.
FAU - Pop, Raoul
AU  - Pop R
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France.
FAU - Proust, Francois
AU  - Proust F
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France.
FAU - Chibbaro, Salvatore
AU  - Chibbaro S
AD  - Dept of Neurosurgery, Strasbourg University Hospital, France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170907
PL  - Scotland
TA  - J Clin Neurosci
JT  - Journal of clinical neuroscience : official journal of the Neurosurgical Society 
      of Australasia
JID - 9433352
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Anticoagulants/administration & dosage/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Neurosurgery
MH  - Neurosurgical Procedures/*adverse effects/standards
MH  - Postoperative Complications/epidemiology/etiology/*prevention & control
MH  - Practice Guidelines as Topic
MH  - Pulmonary Embolism/epidemiology/etiology/*prevention & control
MH  - Venous Thrombosis/epidemiology/etiology/*prevention & control
OTO - NOTNLM
OT  - Deep vein thrombosis
OT  - Intermittent pneumatic compression devices
OT  - Low molecular-weight heparin (LMWH)
OT  - Neurosurgery
OT  - Pulmonary embolism
EDAT- 2017/09/12 06:00
MHDA- 2018/05/12 06:00
CRDT- 2017/09/12 06:00
PHST- 2017/05/21 00:00 [received]
PHST- 2017/08/10 00:00 [accepted]
PHST- 2017/09/12 06:00 [pubmed]
PHST- 2018/05/12 06:00 [medline]
PHST- 2017/09/12 06:00 [entrez]
AID - S0967-5868(17)30958-X [pii]
AID - 10.1016/j.jocn.2017.08.008 [doi]
PST - ppublish
SO  - J Clin Neurosci. 2017 Nov;45:60-66. doi: 10.1016/j.jocn.2017.08.008. Epub 2017 
      Sep 7.