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Internal and Emergency Medicine

, Volume 13, Issue 8, pp 1227–1232 | Cite as

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

  • Carmelo Lucio SturialeEmail author
  • Fabrizio Pignotti
  • Marzia Giordano
  • Angelo Porfidia
  • Alessio Albanese
  • Igor Giarretta
  • Alfredo Puca
  • Eleonora Gaetani
  • Sonia D’Arrigo
  • Ada Truma
  • Alessandro Olivi
  • Roberto Pola
  • Sporadic AVMs-HHT Study Group
IM - ORIGINAL
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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

Brain arteriovenous malformation Antithrombotic therapy Antiplatelet Anticoagulant Aspirin Bleeding Brain haemorrhage 

Notes

Author contributions

All authors have read and approved the submitted manuscript; it has not been submitted elsewhere nor published elsewhere in whole or in part. There are no competing interests.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The protocol was conducted in agreement with the Helsinki declaration. This dataset is completely anonymous and does not contain any identifiable personal data.

Informed consent

Informed consent was obtained from all individual participants included in the study at the time of their hospital admission.

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Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Carmelo Lucio Sturiale
    • 1
    Email author return OK on get
  • Fabrizio Pignotti
    • 1
  • Marzia Giordano
    • 2
  • Angelo Porfidia
    • 2
  • Alessio Albanese
    • 1
  • Igor Giarretta
    • 2
  • Alfredo Puca
    • 1
  • Eleonora Gaetani
    • 2
  • Sonia D’Arrigo
    • 3
  • Ada Truma
    • 2
  • Alessandro Olivi
    • 1
  • Roberto Pola
    • 2
  • Sporadic AVMs-HHT Study Group
  1. 1.Institute of NeurosurgeryFondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro CuoreRomeItaly
  2. 2.Institute of MedicineFondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro CuoreRomeItaly
  3. 3.Institute of Anesthesiology and Intensive CareFondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro CuoreRomeItaly

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