Hamulyák Eva N, Yust-Katz Shlomit, Leader Avi
Department of Internal Medicine, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Neurooncology Unit, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Hematology Am Soc Hematol Educ Program. 2024 Dec 6;2024(1):246-252. doi: 10.1182/hematology.2024000660.
Venous thromboembolism (VTE) is a prevalent and serious complication among cancer patients, necessitating therapeutic anticoagulation for many individuals with brain metastases. Simultaneously, patients with brain metastases, particularly those with high-risk primary tumors, have an increased risk of intracranial hemorrhage (ICH). Managing anticoagulation in these patients presents a dual challenge: preventing thromboembolism while avoiding hemorrhagic events. Here, we present our approach to anticoagulation for acute VTE in patients with brain metastases, based on the available evidence. We review potential risk factors for anticoagulation-associated ICH in this population and discuss strategies for managing acute VTE in patients with and without ICH.
静脉血栓栓塞症（VTE）是癌症患者中常见且严重的并发症，许多脑转移患者需要进行抗凝治疗。同时，脑转移患者，尤其是原发性肿瘤具有高风险的患者，颅内出血（ICH）风险增加。对这些患者进行抗凝管理面临双重挑战：预防血栓栓塞，同时避免出血事件。在此，我们根据现有证据，介绍我们对脑转移患者急性VTE的抗凝治疗方法。我们回顾了该人群中与抗凝相关的颅内出血的潜在危险因素，并讨论了有颅内出血和无颅内出血患者急性VTE的管理策略。
