Cardiovascular complications and post-bleeding rate after perioperative discontinue of oral anticoagulation in neurosurgery

Objective : The aim of the study was to perform a retrospective analysis regarding cardiovascular and thromboembolic events due to interruption or bridging of treatment with anticoagulation in neurosurgical patients. Methods : The clinical course of 314 patients was retroscpectively within 10 days before and 6 weeks after spinal interventions and 3 months after intracranial interventions, were performed electively between January 2011 and December 2013 at our clinic. The oral anticoagulation was interrupted perioperatively. A comparison with the relevant literature between 1996 – 2020 was carried out. Results: In 303 patients (96.5%) was the perioperative course in the meant period normal. In 11 patients (3.5% of total) was cardiovascular and thromboembolic events (N=5; 1.6% of total) or postoperative hemorrhage (N=6; 1.9% of total) documented and only for spinal surgeries. Postoperative hemorrhage occurred in 6 patients (54.5% of complications). Pulmonary embolism occurred in 2 patients (18.2% of complications). The remaining complications (27.3% of complications) were distributed among DVT (N=1), myocardial infarction (N=1), and basilar artery thrombosis (N=1). Conclusion: Considering the literature, there was no increased risk of perioperative cardiovascular complications and thromboembolic events after pausing oral anticoagulation according to standard of our clinic during elective neurosurgical procedures. Just as little was found in an increase in the rate of postoperative hemorrhage.