scholarly journals Usefulness of Prothrombin Complex Concentrate for the Prevention of Postoperative Hemorrhage after the Endoscopic Removal of Hypertensive Intracerebral Hematoma in Patients Receiving Anticoagulants

2021 ◽  
Vol 49 (1) ◽  
pp. 52-58
Author(s):  
Hiroki MATSUNO ◽  
Syuntaro TAKASU ◽  
Yugo KISHIDA ◽  
Tadashi WATANABE ◽  
Tetsuya NAGATANI ◽  
...  
Keyword(s):  
Prothrombin Complex Concentrate ◽  
Postoperative Hemorrhage ◽  
Intracerebral Hematoma ◽  
Endoscopic Removal

Abstract WP365: Role of Enhanced CT Findings in Endoscopic Surgery for Intracerebral Hematoma

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Atsushi Saito ◽  
Hiroyuki Kon ◽  
Taigen Nakamura ◽  
Wenting Jia ◽  
Tatsuya Sasaki ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Perioperative Complications ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Postoperative Hemorrhage ◽  
Hematoma Expansion ◽  
Intracerebral Hematoma ◽  
Negative Group ◽  
Contrast Extravasation ◽  
Positive Group

Objective: In our institute, endoscopic aspiration of hematoma is often performed for acute treatment of intracerebral hematoma (ICH). In some cases, hemostasis is technically difficult to perform during endoscopy, and post-operative hemorrhage may occur. We examined the association between perioperative complications associated with endoscopic surgery for acute ICH, and radiological findings on enhanced computed tomography (CT). Methods: Subjects were 471 patients diagnosed with hypertensive ICH who had been admitted and treated in our institute within 72 hours from onset, between 2012 and 2015. Enhanced CT imaging was performed at admission, and radiological enhancement signs (RES) were defined as CT angiography spot signs in the arterial phase, or contrast extravasation in the parallel phase. RES-positive subjects were grouped and compared with an equal number of RES-negative subjects, and the association between perioperative complications and RES was analyzed. Results: The RES-positive group included 39 subjects; endoscopic surgery was performed in 16 of the 39 subjects. Postoperative hemorrhage occurred in 6 of the 16 subjects. No hemorrhagic complications were found in the RES-negative group. Follow-up CT after 24 hours showed hematoma expansion in 20 of 26 subjects in the RES-positive group and in only 1 of the 39 subjects of the RES-negative group. Statistical analyses showed that the RES-positive group had a significantly shorter duration between the onset of ICH and CT scan and significantly larger hematoma volume, compared with the RES-negative group. Multivariate analysis identified the presence of RES as a significant risk factor of postoperative hemorrhage or hematoma expansion on follow-up CT. Conclusion: CT angiography spot signs or contrast extravasation positive signs were observed with a shorter duration between ICH onset and CT scan, and larger hematomas. These signs may be an important predictive factor for hematoma expansion, as well as a significant risk factor of postoperative hemorrhage after endoscopic surgery for ICH.

Chronic expanding intracerebral hematoma

1986 ◽  
Vol 65 (5) ◽  
pp. 611-614 ◽  
Author(s):  
Eugenio Pozzati ◽  
Giuliano Giuliani ◽  
Giulio Gaist ◽  
Giancarlo Piazza ◽  
Gilberto Vergoni
Keyword(s):  
Clinical Presentation ◽  
White Matter Lesions ◽  
Mass Effect ◽  
Postoperative Hemorrhage ◽  
Intracerebral Hematoma ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Collagenous Tissue ◽  
Perifocal Edema ◽  
Fine Print

✓ The cases of 10 normotensive patients with chronic intracerebral hematomas are reported. The patients' median age at diagnosis was 42 years. The median duration of symptoms was 22 days. Seizures were thepresenting symptom in 50% of the cases. Computerized tomography almost consistently demonstrated ring-shaped lesions with mass effect and perifocal edema. Arteriography revealed that all but one of the lesions were avascular. All patients had superficial white matter lesions, mostly in the frontoparietal region. All patients were treated surgically. Most of the hematomas were encapsulated and contained blood in various stages of organization. The thick capsule consisted of an outer layer of collagenous tissue and an inner layer of granulation tissue. Occult cerebrovascular malformations were detected in two instances. There were two deaths, both related to recurrent postoperative hemorrhage. This entity can present much like a brain malignancy and should be considered in the differential diagnosis of ring-shaped lesions whatever the clinical presentation. Strategies of treatment are discussed.

Prothrombin complex concentrate

1977 ◽  
Vol 137 (9) ◽  
pp. 1211-1213 ◽  
Author(s):  
R. T. DeWitt
Keyword(s):  
Prothrombin Complex Concentrate

Neuroendoscope-Assisted Technique for Evacuation of Intracerebral Hematoma with Penetration into the Ventricular System

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
B. Iliev ◽  
Y. Enchev ◽  
T. Avramov ◽  
Pl. Trendafilov ◽  
T. Kondev ◽  
...  
Keyword(s):  
Ventricular System ◽  
Intracerebral Hematoma

The Endothelial Cell and the Factor VIII Bypassing Activity of Prothrombin Complex Concentrate

1988 ◽  
Vol 60 (02) ◽  
pp. 226-229 ◽  
Author(s):  
Jerome M Teitel ◽  
Hong-Yu Ni ◽  
John J Freedman ◽  
M Bernadette Garvey
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Vascular Endothelial Cells ◽  
Vascular Endothelial ◽  
Monolayer Cultures ◽  
Coagulant Activity ◽  
Time Courses ◽  
Privileged Site

SummarySome classical hemophiliacs have a paradoxical hemostatic response to prothrombin complex concentrate (PCC). We hypothesized that vascular endothelial cells (EC) may contribute to this “factor VIII bypassing activity”. When PCC were incubated with suspensions or monolayer cultures of EC, they acquired the ability to partially bypass the defect of factor VIII deficient plasma. This factor VIII bypassing activity distributed with EC and not with the supernatant PCC, and was not a general property of intravascular cells. The effect of PCC was even more dramatic on fixed EC monolayers, which became procoagulant after incubation with PCC. The time courses of association and dissociation of the PCC-derived factor VIII bypassing activity of fixed and viable EC monolayers were both rapid. We conclude that EC may provide a privileged site for sequestration of constituents of PCC which express coagulant activity and which bypass the abnormality of factor VIII deficient plasma.

Comparison of High Purity Factor IX Concentrates and a Prothrombin Complex Concentrate in a Canine Model of Thrombogenicity

1991 ◽  
Vol 66 (05) ◽  
pp. 609-613 ◽  
Author(s):  
I R MacGregor ◽  
J M Ferguson ◽  
L F McLaughlin ◽  
T Burnouf ◽  
C V Prowse
Keyword(s):  
High Purity ◽  
Time Course ◽  
Prothrombin Complex Concentrate ◽  
Degradation Products ◽  
Canine Model ◽  
Factor Ix ◽  
In Vitro Tests ◽  
Albumin Infusion

SummaryA non-stasis canine model of thrombogenicity has been used to evaluate batches of high purity factor IX concentrates from 4 manufacturers and a conventional prothrombin complex concentrate (PCC). Platelets, activated partial thromboplastin time (APTT), fibrinogen, fibrin(ogen) degradation products and fibrinopeptide A (FPA) were monitored before and after infusion of concentrate. Changes in FPA were found to be the most sensitive and reproducible indicator of thrombogenicity after infusion of batches of the PCC at doses of between 60 and 180 IU/kg, with a dose related delayed increase in FPA occurring. Total FPA generated after 100-120 IU/kg of 3 batches of PCC over the 3 h time course was 9-12 times that generated after albumin infusion. In contrast the amounts of FPA generated after 200 IU/kg of the 4 high purity factor IX products were in all cases similar to albumin infusion. It was noted that some batches of high purity concentrates had short NAPTTs indicating that current in vitro tests for potential thrombogenicity may be misleading in predicting the effects of these concentrates in vivo.

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