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Related Experiment Videos

Phenprocoumon from a neurosurgical perspective.

G Sandvoss1, W Erdlenbruch, B Krischek

  • 1Neurosurgical Department, Ludmillenstift Hospital, Meppen, Germany.

Seminars in Thrombosis and Hemostasis
|May 18, 1999
PubMed
Summary

Oral anticoagulant treatment with phenprocoumon can lead to serious intracranial and spinal hematomas. Improving standards for anticoagulant therapy and monitoring may reduce these life-threatening complications.

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Area of Science:

  • Neurosurgery
  • Hematology
  • Pharmacology

Background:

  • Oral anticoagulant therapy, particularly with phenprocoumon, is associated with a risk of intracranial and spinal hematomas.
  • Previous studies have highlighted the incidence of such hemorrhages, but comprehensive analysis is needed.

Purpose of the Study:

  • To analyze a series of intracranial and spinal hematomas in patients on phenprocoumon therapy.
  • To compare findings with existing literature and estimate the incidence of these complications in Germany.
  • To identify factors contributing to these hemorrhages and suggest measures for reduction.

Main Methods:

  • Retrospective analysis of 45 cases of intracranial and spinal hematomas over a 9-year period.
  • Review of patient data including age, indication for anticoagulation, and International Normalized Ratio (INR) values.

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  • Comparison of collected data with published literature on anticoagulant-related hemorrhages.

    • Main Results:

    • 42% of patients presented with INR values >4.5; 36% were over 70 years old.
    • Cardiac valve replacement was the most common indication for long-term anticoagulation (38%).
    • An estimated 650 hematomas, with 250 fatalities annually, occur in Germany due to oral anticoagulants.

    Conclusions:

    • Intracranial and spinal hematomas under phenprocoumon treatment represent a significant neurosurgical complication.
    • Current standards for indications, clinical control, and INR testing require improvement, with targets not exceeding 4.0.
    • Further data collection on incidence and causative factors is crucial to reduce fatalities.