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Peri‐procedural Anticoagulation in Patients with Head and Neck Versus Extremity Venous Malformations
Author(s) -
Dharmarajan Harish,
McCoy Jennifer L.,
Jabbour Noel,
McCormick Andrew,
Xavier Frederico,
Correa Debra,
Padia Reema
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29123
Subject(s) - medicine , thrombus , incidence (geometry) , head and neck , sclerotherapy , venous thrombosis , venous thromboembolism , perioperative , surgery , d dimer , thrombosis , physics , optics
Objective (1) Review a multidisciplinary vascular anomalies center's practice regarding periprocedural anticoagulation for venous malformations (VM) and the associated risk of thromboembolic and disseminated intravascular coagulation (DIC) events. (2) Compare the risk of thromboembolic events and DIC post‐procedure between head and neck (H&N) and extremity VM patients. Methods An Institutional Review Board (IRB)‐approved, retrospective chart review was performed on 120 VM patients. A thromboembolic event was defined as a thrombus formation post‐sclerotherapy or post‐surgery within 2 months in a distant or local venous structure not directly addressed by the procedure. Results There were 39 cases involving the H&N and 81 cases based at the extremities. There were eight cases of post‐procedure thrombus formation within the extremity VM group (8/71; 11.3%) as opposed to 0 cases in the H&N group (OR: 0, 95% CI .00–.09), p = .049. There was no difference in incidence of post‐procedure thromboembolic events between those with elevated D‐dimer (H&N: 0%, extremity: 22.7%, 5/22) and normal D‐dimer values (H&N: 0%, extremity: 6.3% [1/16], P = .370). There was no difference in incidence of post‐procedure thromboembolic events between those who received periprocedural anticoagulation (H&N: 0%, extremity: 21%, 4/19) and those who did not (H&N: 0%, extremity: 8.2%, 4/49), (Extremity: OR: 3.00, .67–13.50, P = .206). Conclusion Post‐procedure thromboembolism is rare in the treatment of venous malformations, especially in the head and neck subsite. Regardless of anticoagulation use, there were no thromboembolic events for H&N VM patients. Such events are rare, and the odds may approach zero, especially with small sample size. Level of Evidence 4 Laryngoscope , 131:1163–1167, 2021