- Anticoagulate in patients with brain tumors and VTE except if risk of ICH is high: i.e.
- melanoma mets
- renal cell carcinoma mets
- choriocarcinoma mets
- thyroid carcinoma mets
- treat x 3-6 months; long term if malignant gliomas
- LMWH recommended versus warfarin
- If risk of ICH high:
- IVC filter if significant residual brain mets
- if mets already removed / treated effectively and medical condition too unstable – anticoagulate
- do not anticoagulate except in post-operative period
- use SCDs with post-op LMWH or UFH 12-24 hours after surgery
- cotninue prophylaxis until ambulation resumed
Uptodate. “Anticoagulant and antiplatelet therapy in patients with brain tumors.” Accessed 08/12/2016.
Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25:5490.