title: Decision-making in a patient with cardiac arrest due to venous thromboembolism within 24 h after glioblastoma resection.
abstract: In the fulminant VTE form with cardiac arrest, systemic thrombolysis remains the most effective therapy. However, several contraindications restrict the use such as intracranial neoplasm or a recent history of intracranial surgery. Here, we report the case of a 59-year-old man who underwent glioblastoma resection and suffered from a fulminant pulmonary embolism with cardiac arrest. After CPR, continuous tPA infusion via an endovascularly placed pulmonary catheter was maintained over a period of 8 h. In this case, we report on our decision-making process and the use of local thrombolysis as a successful therapy in a patient with multiple contraindications.
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany. daniel.dubinski@kgu.de.
authors.forename: D
authors.identifier: 0000-0001-5568-8429
authors.initials: D
authors.lastname: Dubinski
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Won
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bruder
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: M-T
authors.initials: MT
authors.lastname: Forster
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Seifert
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Senft
authors.affiliation: Institute of Neuroradiology, Goethe University, Frankfurt, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Berkefeld
authors.affiliation: Department of Neurosurgery, University Hospital, Goethe University, Frankfurt, Germany.|Clinic of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital, Goethe University, Frankfurt, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Mersmann
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D000066491:Clinical Decision-Making; D005909:Glioblastoma / Q000601:surgery*; D006323:Heart Arrest / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology
keywords: Cardiac arrest; GBM; Intracranial hemorrhage; Lysis contraindication