title: Hemorrhage rates of external ventricular drain (EVD), intracranial pressure gauge (ICP) or combined EVD and ICP gauge placement within 48 h of endovascular coil embolization of cerebral aneurysms.
abstract: OBJECTIVE
  In single patients with a cerebral aneurysm an external ventricular drain (EVD), an intracranial pressure (ICP) gauge or a combined EVD and ICP gauge placement is necessary after coil embolization and initiation of postprocedural anticoagulation. The aim of this study was to examine the hemorrhage rates of drain placement within 48 h after aneurysm coiling and under anticoagulation or antiplatelet therapy.
  
  
  METHODS
  We retrospectively analyzed hemorrhage rates of EVD, ICP gauge or combined EVD and ICP gauge placement in 27 patients within 48 h after coil embolization under different anticoagulation or antiplatelet schemes (heparin, acetylsalicylic acid, clopidogrel). In patients with continuous heparin via perfusor the application was stopped periprocedurally. The results were compared to literature.
  
  
  RESULTS
  Four hemorrhages (14.8%) were observed. Three hemorrhages were petechial and one was by definition a larger hemorrhage with 8 mm×10 mm in diameter.
  
  
  CONCLUSIONS
  EVD, ICP gauge or combined EVD and ICP gauge placements within 48 h after cerebral aneurysm coiling and under different anticoagulation or antiplatelet regimens seem to have no increased risk of hemorrhages compared to literature.
authors: Department of General Neurosurgery, University of Freiburg Medical School, Breisacher Str. 64, D-79106 Freiburg, Germany. christoph.scholz@uniklinik-freiburg.de
authors: Christoph
authors: C
authors: Scholz
authors: Ulrich
authors: U
authors: Hubbe
authors: Miriam
authors: M
authors: Deininger
authors: Martin H
authors: MH
authors: Deininger
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D004322:Drainage / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000009:adverse effects* / Q000295:instrumentation*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin
keywords: Anticoagulation; Cerebral aneurysm; Coil embolization; External ventricular drainage; ICP gauge; Subarachnoidal hemorrhage