COMPLICATIONS OF THERAPY FOR VENOUS THROMBOEMBOLIC DISEASE IN PATIENTS WITH BRAIN-TUMORS

Venous thromboembolic disease is a frequent complication in patients w ith intracranial malignancies. Because these patients are often percei ved to be at increased risk of intracranial hemorrhage with anticoagul ation, inferior vena cava (IVC) filters are frequently used in their t reatment. We reviewed the records of 49 patients with intracranial mal ignancies and venous thromboembolic disease to determine the effective ness of, and the complications resulting from, treatment. Of the 42 pa tients receiving IVC filters, a strikingly high percentage (62%) devel oped complications. Twelve percent developed recurrent pulmonary embol ism, while 57% developed either IVC or filter thrombosis, recurrent de ep venous thrombosis, or post-phlebitic syndrome. These complications severely reduced the quality of life of the affected patients. Only 15 of our patients were treated with anticoagulation, and seven of these received it because of continued thromboembolic disease. None of thes e 15 patients had proven hemorrhagic complications. This study suggest s that the complication rate of IVC filters in patients with brain tum ors is higher than commonly perceived and may outweigh the risk of ant icoagulation.