title: Haemorrhagic Complications and Symptomatic Venous Thromboembolism in Interventional Tumour Ablations: The Impact of Peri-interventional Thrombosis Prophylaxis.
abstract: OBJECTIVE
  The aim of this study was to assess the rates of haemorrhagic and thrombotic complications in patients undergoing interventional tumour ablation with and without peri-interventional low-molecular-weight heparin (LMWH) thrombosis prophylaxis.
  
  
  METHODS
  Patients presented with primary and secondary neoplastic lesions in the liver, lung, kidney, lymph nodes and other locations. A total of 781 tumour ablations (radiofrequency ablation, n = 112; interstitial brachytherapy, n = 669) were performed in 446 patients over 22 months; 260 were conducted under peri-interventional thrombosis prophylaxis with LMWH (H-group;) and 521 without this (NH-group, in 143 of these, LMWH was given post-interventionally).
  
  
  RESULTS
  Sixty-three bleeding events occurred. There were significantly more bleedings in the H-group than in the NH-group (all interventions, 11.66 and 6.26 %, p = 0.0127; liver ablations, 12.73 and 7.1 %, p = 0.0416). The rate of bleeding events Grade ≥ III in all procedures was greater by a factor of >2.6 in the H-group than in the NH-group (4.64 and 1.73 %, p = 0.0243). In liver tumour ablations, the corresponding factor was about 3.3 (5.23 and 1.54 %, p = 0.028). In uni- and multivariate analyses including covariates, the only factor constantly and significantly associated with the rate of haemorrhage events was peri-interventional LMWH prophylaxis. Only one symptomatic lung embolism occurred in the entire cohort (NH-group). The 30- and 90-day mortalities were significantly greater in the H-group than in the NH-group.
  
  
  CONCLUSIONS
  Peri-interventional LMWH thrombosis prophylaxis should be considered with caution. The rate of clinically relevant thrombotic events was extremely low.
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany. konrad.mohnike@med.ovgu.de.
authors.forename: Konrad
authors.initials: K
authors.lastname: Mohnike
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Sauerland
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Seidensticker
authors.affiliation: Klinik für Strahlentherapie, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hass
authors.affiliation: Institut für Biometrie, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kropf
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Ricarda
authors.initials: R
authors.lastname: Seidensticker
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Friebe
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Fischbach
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Fischbach
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Maciej
authors.initials: M
authors.lastname: Powerski
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Maciej
authors.initials: M
authors.lastname: Pech
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: O S
authors.initials: OS
authors.lastname: Grosser
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: Kettner
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
keywords: Ablation; Bleeding events; Brachytherapy; Complications; Heparin; LMWH; RFA