PREVENTION OF DEEP-VEIN THROMBOSIS IN NEUROSURGICAL PATIENTS WITH BRAIN-TUMORS - A CONTROLLED, RANDOMIZED STUDY COMPARING GRADED COMPRESSION STOCKINGS ALONE AND WITH INTERMITTENT SEQUENTIAL COMPRESSION - CORRELATION WITH PREOPERATIVE AND POSTOPERATIVE FIBRINOLYSIS - PRELIMINARY-RESULTS

Postoperative venous thromboembolism is a common problem in neurosurge ry. Moreover, patients with brain tumors have an increasing risk of de veloping deep vein thrombosis (DVT), depending on the histology of the tumor. The aim of this study is to compare graded compression stockin gs (GCS) alone and GCS combined with intermittent gradient sequential pneumatic compression (GCS/IPC) for the prevention of postoperative DV T in patients undergoing brain tumor surgery. The primary endpoint is a bilateral ascending phlebogram obtained on the 8th postoperative day . Preliminary results are available on 23 patients who completed the s tudy. The incidence of postoperative DVT was 40% (2/5) in the GCS grou p and 0% (0/18) in the GCS/IPC group. Both patients with DVT had menin gioma. There was no clear association between pre- and postoperative f ibrinolytic activity estimated by euglobulin clot lysis time and D-dim er level. These preliminary results suggest that GCS combined with IPC is more effective than GCS alone in preventing postoperative DVT in p atients undergoing brain tumor surgery. However, the sample size is no t sufficient to draw a definite conclusion.