Antithrombotic therapy and intracranial bleeding in subjects with sporadic brain arteriovenous malformations: preliminary results from a retrospective study.
Carmelo Lucio SturialeFabrizio PignottiMarzia GiordanoAngelo PorfidiaAlessio AlbaneseIgor GiarrettaAlfredo PucaEleonora GaetaniSonia D'ArrigoAda TrumaAlessandro OliviRoberto Polanull nullPublished in: Internal and emergency medicine (2018)
Whether antithrombotic treatment is safe and/or affects the risk of intracranial bleeding in subjects with sporadic brain arteriovenous malformations (AVMs) is unknown. We conducted a retrospective analysis on the use of antithrombotics among patients affected by brain AVMs in follow-up at our institution. Attention was paid to the type of antithrombotic drug (either antiplatelets or anticoagulants), current or past use, dosage, and duration of treatment. Several clinical and angioarchitectural features of brain AVMs were also taken into consideration. The association between the use of antithrombotics and haemorrhagic onset was analyzed. A total of 77 patients were included in this study. Among them, ten patients were taking antithrombotic drugs at the time of AVM diagnosis. The rate of haemorrhagic onset was not significantly different between subjects who were and were not taking antithrombotic drugs (40 vs 55.2%, p = ns). Among the many clinical and angioarchitectural features analyzed, the only parameter that showed a statistically significant association with haemorrhagic onset was the size of the nidus. Patients who took antithrombotic treatments after being diagnosed with a brain AVM did not show an increased rate of intracranial haemorrhage over time considering a mean follow-up 4 years. In our study, antithrombotic treatment was not associated with increased intracranial bleeding among subjects with brain AVMs. In the presence of a strong clinical indication, antiplatelet and anticoagulant medications should not be denied a priori to patients with brain AVMs. Studies on larger populations are necessary to confirm these data.
Keyphrases
- atrial fibrillation
- resting state
- white matter
- end stage renal disease
- functional connectivity
- cerebral ischemia
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- emergency department
- venous thromboembolism
- prognostic factors
- late onset
- multiple sclerosis
- blood brain barrier
- deep learning
- subarachnoid hemorrhage
- data analysis