Venous thromboembolic complications with and without intermittent intraoperative and postoperative pneumatic...

Area of Science:

• Neurosurgery
• Vascular Surgery
• Oncology

Background:

• Glioblastoma multiforme (GBM) patients undergoing intracranial surgery face a high risk of thromboembolic complications.
• Standard thromboprophylaxis includes compression stockings, low-molecular weight heparin (LMWH), and physiotherapy.
• The role of intermittent pneumatic compression (IPC) as an adjunct in this patient population requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of intraoperative and postoperative intermittent pneumatic compression (IPC) in reducing deep venous thrombosis (DVT) incidence.
• To compare IPC with standard thromboprophylaxis methods in patients undergoing glioblastoma multiforme (GBM) surgery.
• To assess the impact of IPC on pulmonary embolism (PE) rates post-neurosurgery.

Main Methods:

• A retrospective study of 153 patients who underwent intracranial surgery for GBM with intraoperative MRI guidance.
• Patients were divided into two groups: 75 with additional IPC and 78 without IPC.
• Both groups received standard thromboprophylaxis; DVT and PE were screened postoperatively via Doppler ultrasonography and CT scans.

Main Results:

• Deep venous thrombosis (DVT) occurred in 8% of patients with IPC versus 3.9% without IPC (P=0.33), a non-significant increase.
• Pulmonary embolism (PE) incidence showed a non-significant reduction from 2.6% to 1.3% with IPC (P=0.59).
• The study found no statistically significant difference in thromboembolic complications between the groups.

Conclusions:

• Intraoperative and postoperative IPC did not significantly decrease DVT or PE incidence in GBM patients compared to standard prophylaxis.
• The low complication rates suggest that surgical intervention, immobilization, and existing thromboprophylaxis may be more influential than anticipated.
• Larger patient cohorts are necessary to detect statistically significant effects of IPC or to explore alternative mechanisms for coagulopathy in GBM patients.