ArticleActa neurochirurgica2021
Deep brain stimulation in patients on chronic antiplatelet or anticoagulation treatment.
Article in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Do Antibiotic-Impregnated Envelopes Prevent Deep Brain Stimulation Implantable Pulse Generator Infections? A Prospective Cohort Study.Stereotactic and functional neurosurgery · 2024Trial
- Denial of Hardware-Related Skin Erosion in Patients with Effective Deep Brain Stimulation: A Novel Phenomenon.Stereotactic and functional neurosurgery · 2026Article
- MR-guided focused ultrasound thalamotomy in a patient with thrombocytopenia: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Risk of Cerebrovascular Events in Deep Brain Stimulation for Parkinson's Disease Focused on STN and GPi: Systematic Review and Meta-Analysis.Brain sciences · 2025Review
- Cerebral Intraparenchymal Hemorrhage due to Implantation of Electrodes for Deep Brain Stimulation: Insights from a Large Single-Center Retrospective Cross-Sectional Analysis.Brain sciences · 2024Article
- Magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor in a patient with von Willebrand disease: perioperative optimization for patients with coagulopathies. Illustrative case.Journal of neurosurgery. Case lessons · 2024Article
- Somatosensory evoked potentials recorded from DBS electrodes: the origin of subcortical N18.Journal of neural transmission (Vienna, Austria : 1996) · 2024Article
- Intravenous thrombolysis and mechanical recanalization for acute ischemic stroke in deep brain stimulation patients: a case series.Journal of neurology · 2023Review
- Subthalamic Nucleus Deep Brain Stimulation Treats Parkinson's Disease Patients with Cardiovascular Disease Comorbidity: A Retrospective Study of a Single Center Experience.Brain sciences · 2022Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the aging society, many patients with movement disorders, pain syndromes, or psychiatric disorders who are candidates for deep brain stimulation (DBS) surgery suffer also from cardiovascular co-morbidities that require chronic antiplatelet or anticoagulation treatment. Because of a presumed increased risk of intracranial hemorrhage during or after surgery and limited knowledge about perioperative management, chronic antiplatelet or anticoagulation treatment often has been considered a relative contraindication for DBS. Here, we evaluate whether or not there is an increased risk for intracranial hemorrhage or thromboembolic complications in patients on chronic treatment (paused for surgery or bridged with subcutaneous heparin) as compared to those without.
methodsOut of a series of 465 patients undergoing functional stereotactic neurosurgery, 34 patients were identified who were on chronic treatment before and after receiving DBS. In patients with antiplatelet treatment, medication was stopped in the perioperative period. In patients with vitamin K antagonists or novel oral anticoagulants (NOACs), heparin was used for bridging. All patients had postoperative stereotactic CT scans, and were followed up for 1 year after surgery.
resultsIn patients on chronic antiplatelet or anticoagulation treatment, intracranial hemorrhage occurred in 2/34 (5.9%) DBS surgeries, whereas the rate of intracranial hemorrhage was 15/431 (3.5%) in those without, which was statistically not significant. Implantable pulse generator pocket hematomas were seen in 2/34 (5.9%) surgeries in patients on chronic treatment and in 4/426 (0.9%) without. There were only 2 instances of thromboembolic complications which both occurred in patients without chronic treatment. There were no hemorrhagic complications during follow-up for 1 year.
conclusionsDBS surgery in patients on chronic antiplatelet or anticoagulation treatment is feasible. Also, there was no increased risk of hemorrhage in the first year of follow-up after DBS surgery. Appropriate patient selection and standardized perioperative management are necessary to reduce the risk of intracranial hemorrhage and thromboembolic complications.
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