Antithrombotic therapy and intracranial bleeding in subjects with sporadic brain arteriovenous malformations: preliminary results from a retrospective study

Sporadic AVMs-HHT Study Group

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalInternal and Emergency Medicine
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Arteriovenous Malformations
Retrospective Studies
Hemorrhage
Brain
Anticoagulants
Therapeutics
Intracranial Hemorrhages
Platelet Aggregation Inhibitors
Pharmaceutical Preparations
Population

Keywords

  • Anticoagulant
  • Antiplatelet
  • Antithrombotic therapy
  • Aspirin
  • Bleeding
  • Brain arteriovenous malformation
  • Brain haemorrhage

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

Cite this

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title = "Antithrombotic therapy and intracranial bleeding in subjects with sporadic brain arteriovenous malformations: preliminary results from a retrospective study",
abstract = "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.",
keywords = "Anticoagulant, Antiplatelet, Antithrombotic therapy, Aspirin, Bleeding, Brain arteriovenous malformation, Brain haemorrhage",
author = "{Sporadic AVMs-HHT Study Group} and Sturiale, {Carmelo Lucio} and Fabrizio Pignotti and Marzia Giordano and Angelo Porfidia and Alessio Albanese and Igor Giarretta and Alfredo Puca and Eleonora Gaetani and Sonia D’Arrigo and Ada Truma and Alessandro Olivi and Roberto Pola",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s11739-018-1918-7",
language = "English (US)",
journal = "Internal and Emergency Medicine",
issn = "1828-0447",
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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

PY - 2018/1/1

Y1 - 2018/1/1

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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