TY - JOUR
T1 - Antithrombotic therapy and intracranial bleeding in subjects with sporadic brain arteriovenous malformations
T2 - preliminary results from a retrospective study
AU - Sporadic AVMs-HHT Study Group
AU - Sturiale, Carmelo Lucio
AU - Pignotti, Fabrizio
AU - Giordano, Marzia
AU - Porfidia, Angelo
AU - Albanese, Alessio
AU - Giarretta, Igor
AU - Puca, Alfredo
AU - Gaetani, Eleonora
AU - D’Arrigo, Sonia
AU - Truma, Ada
AU - Olivi, Alessandro
AU - Pola, Roberto
N1 - Publisher Copyright:
© 2018, Società Italiana di Medicina Interna.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - 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.
AB - 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.
KW - Anticoagulant
KW - Antiplatelet
KW - Antithrombotic therapy
KW - Aspirin
KW - Bleeding
KW - Brain arteriovenous malformation
KW - Brain haemorrhage
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U2 - 10.1007/s11739-018-1918-7
DO - 10.1007/s11739-018-1918-7
M3 - Article
C2 - 30062529
AN - SCOPUS:85051120128
SN - 1828-0447
VL - 13
SP - 1227
EP - 1232
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
IS - 8
ER -