Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review

Abstract Background Patients with spontaneous intracerebral hemorrhage (ICH) have a higher risk of venous thromboembolism (VTE) and in-hospital VTE is independently associated with poor outcomes for this patient population. Methods A comprehensive literature search about patients with VTE after spon...

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Autores principales:	Qiyan Cai, Xin Zhang, Hong Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Intracerebral hemorrhage Venous thromboembolism Pulmonary embolism Deep venous thrombosis Anticoagulation Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/fc39dcec79184f8f84e04834b5b0b70c
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spelling	oai:doaj.org-article:fc39dcec79184f8f84e04834b5b0b70c2021-11-28T12:25:34ZPatients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review10.1186/s12959-021-00345-z1477-9560https://doaj.org/article/fc39dcec79184f8f84e04834b5b0b70c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12959-021-00345-zhttps://doaj.org/toc/1477-9560Abstract Background Patients with spontaneous intracerebral hemorrhage (ICH) have a higher risk of venous thromboembolism (VTE) and in-hospital VTE is independently associated with poor outcomes for this patient population. Methods A comprehensive literature search about patients with VTE after spontaneous ICH was conducted using databases MEDLINE and PubMed. We searched for the following terms and other related terms (in US and UK spelling) to identify relevant studies: intracerebral hemorrhage, ICH, intraparenchymal hemorrhage, IPH, venous thromboembolism, VTE, deep vein thrombosis, DVT, pulmonary embolism, and PE. The search was restricted to human subjects and limited to articles published in English. Abstracts were screened and data from potentially relevant articles was analyzed. Results The prophylaxis and treatment of VTE are of vital importance for patients with spontaneous ICH. Prophylaxis measures can be mainly categorized into mechanical prophylaxis and chemoprophylaxis. Treatment strategies include anticoagulation, vena cava filter, systemic thrombolytic therapy, catheter-based thrombus removal, and surgical embolectomy. We briefly summarized the state of knowledge regarding the prophylaxis measures and treatment strategies of VTE after spontaneous ICH in this review, especially on chemoprophylaxis and anticoagulation therapy. Early mechanical prophylaxis, especially with intermittent pneumatic compression, is recommended by recent guidelines for patients with spontaneous ICH. While decision-making on chemoprophylaxis and anticoagulation therapy evokes debate among clinicians, because of the concern that anticoagulants may increase the risk of recurrent ICH and hematoma expansion. Uncertainty still exists regarding optimal anticoagulants, the timing of initiation, and dosage. Conclusion Based on current evidence, we deem that initiating chemoprophylaxis with UFH/LMWH within 24–48 h of ICH onset could be safe; anticoagulation therapy should depend on individual clinical condition; the role of NOACs in this patient population could be promising.Qiyan CaiXin ZhangHong ChenBMCarticleIntracerebral hemorrhageVenous thromboembolismPulmonary embolismDeep venous thrombosisAnticoagulationDiseases of the blood and blood-forming organsRC633-647.5ENThrombosis Journal, Vol 19, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Intracerebral hemorrhage Venous thromboembolism Pulmonary embolism Deep venous thrombosis Anticoagulation Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Intracerebral hemorrhage Venous thromboembolism Pulmonary embolism Deep venous thrombosis Anticoagulation Diseases of the blood and blood-forming organs RC633-647.5 Qiyan Cai Xin Zhang Hong Chen Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
description	Abstract Background Patients with spontaneous intracerebral hemorrhage (ICH) have a higher risk of venous thromboembolism (VTE) and in-hospital VTE is independently associated with poor outcomes for this patient population. Methods A comprehensive literature search about patients with VTE after spontaneous ICH was conducted using databases MEDLINE and PubMed. We searched for the following terms and other related terms (in US and UK spelling) to identify relevant studies: intracerebral hemorrhage, ICH, intraparenchymal hemorrhage, IPH, venous thromboembolism, VTE, deep vein thrombosis, DVT, pulmonary embolism, and PE. The search was restricted to human subjects and limited to articles published in English. Abstracts were screened and data from potentially relevant articles was analyzed. Results The prophylaxis and treatment of VTE are of vital importance for patients with spontaneous ICH. Prophylaxis measures can be mainly categorized into mechanical prophylaxis and chemoprophylaxis. Treatment strategies include anticoagulation, vena cava filter, systemic thrombolytic therapy, catheter-based thrombus removal, and surgical embolectomy. We briefly summarized the state of knowledge regarding the prophylaxis measures and treatment strategies of VTE after spontaneous ICH in this review, especially on chemoprophylaxis and anticoagulation therapy. Early mechanical prophylaxis, especially with intermittent pneumatic compression, is recommended by recent guidelines for patients with spontaneous ICH. While decision-making on chemoprophylaxis and anticoagulation therapy evokes debate among clinicians, because of the concern that anticoagulants may increase the risk of recurrent ICH and hematoma expansion. Uncertainty still exists regarding optimal anticoagulants, the timing of initiation, and dosage. Conclusion Based on current evidence, we deem that initiating chemoprophylaxis with UFH/LMWH within 24–48 h of ICH onset could be safe; anticoagulation therapy should depend on individual clinical condition; the role of NOACs in this patient population could be promising.
format	article
author	Qiyan Cai Xin Zhang Hong Chen
author_facet	Qiyan Cai Xin Zhang Hong Chen
author_sort	Qiyan Cai
title	Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
title_short	Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
title_full	Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
title_fullStr	Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
title_full_unstemmed	Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
title_sort	patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/fc39dcec79184f8f84e04834b5b0b70c
work_keys_str_mv	AT qiyancai patientswithvenousthromboembolismafterspontaneousintracerebralhemorrhageareview AT xinzhang patientswithvenousthromboembolismafterspontaneousintracerebralhemorrhageareview AT hongchen patientswithvenousthromboembolismafterspontaneousintracerebralhemorrhageareview
_version_	1718407992408276992

Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review

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