Evidence map›Paper›PMID 40415083›Full record

ArticlePituitary2025

Symptomatic venous thromboembolism after transsphenoidal surgery in Cushing's disease: incidence and risk factors.

Masaaki Mikamoto, Ye Rim Chang, Hang Lee, Nicholas A Tritos, Lisa B Nachtigall, Brooke Swearingen, Karen K Miller, Pamela S Jones

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Article in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Masaaki MikamotoDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Ye Rim ChangDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Hang LeeMassachusetts General Hospital Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Nicholas A TritosNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Lisa B NachtigallNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Brooke SwearingenDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Karen K MillerNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Pamela S JonesDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. psjones@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-4573-3641

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCushing's Disease (CD) has been linked to increased venous thromboembolism (VTE) risk. This study investigates the incidence and risk factors of postoperative VTE in patients undergoing transsphenoidal surgery (TSS) for CD.

methodsThis retrospective study analyzed patients with CD and non-functioning pituitary adenomas (NFPAs) who underwent TSS at Massachusetts General Hospital from 2005 to 2019. The incidence of VTE within 90 days post-TSS was compared between groups, with early VTE defined as occurring within 7 days. VTE diagnosis was confirmed through imaging, including ultrasound and CT, following clinical suspicion.

resultsOf six CD patients with symptomatic post-TSS VTE, five developed VTE within one week ("early"), while no NFPA patients experienced early VTE (p = 0.006). Two CD patients presented with pulmonary embolism (PE) on postoperative day (POD) 1 or 2. Two of three with early deep venous thrombosis (DVT) had a history of prior DVT. The overall post-TSS VTE incidence was similar between CD and NFPA patients [6/315 (1.9%) vs. 4/559 (0.7%), p = 0.18]. Patients with CD who developed post-TSS VTE had significantly higher rates of prior history of VTE (p = 0.003) and hypertension (p = 0.038) and larger tumor sizes (p = 0.045) compared to those without post-TSS VTE on univariate analysis.

conclusionCD patients are at higher risk for early post-TSS VTE, including symptomatic PE. Identifying high-risk patients and implementing perioperative prophylaxis in the immediate postoperative period may help mitigate these complications. Further research is needed to optimize prevention strategies in this population.

Indexed as

Pituitary ACTH HypersecretionPostoperative ComplicationsVenous ThromboembolismAdenomaAdultAgedFemaleHumansIncidenceMaleMiddle AgedPituitary NeoplasmsPulmonary EmbolismRetrospective StudiesRisk FactorsCushing’s diseaseDeep venous thrombosisPituitary adenomaPulmonary embolismTranssphenoidal surgeryVenous thromboembolism

Identifiers

PMID40415083

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.