Extended Prophylactic Anticoagulation Following Neurosurgery for Metastatic Disease

Grant Application

James Bayley, MD, UPMC Shadyside/UPMC Hillman Cancer Center

Proposed Innovation

New therapies have made it possible for patients with severe diseases to live longer. For patients with metastatic diseases of the brain or spine, surgeons are increasingly performing surgery to extend their lifespans.

Venous thromboembolism (VTE), or a blood clot that forms in the vein, is a common complication among patients with cancer. Extended use of blood thinners has been effective in preventing VTEs after hip and knee surgeries. But neurosurgeons are reluctant to use it after brain or spinal cord surgery because of the risk of bleeding and severe neurologic injury.

This project aims to test the theory that extending the prophylactic use of oral blood thinners is safe and effective in preventing VTEs after brain or spine surgery for metastatic cancer.

Improvements in Action

Through this project, a pilot study will be conducted at UPMC Shadyside to help researchers understand the benefit of providing longer anticoagulation for patients undergoing surgery for metastatic disease. The project will involve a series of patients receiving an extended course of oral blood thinners after surgery and comparing their rate of blood clots to historical controls.

Intended Outcomes

Researchers believe this project offers the potential for a larger study funded by the National Institutes of Health or National Cancer Institute. It could also lead to similar studies in other patient populations, including those undergoing surgery for primary brain tumors, spinal deformities, and other conditions — potentially shaping the future standard of care for millions of patients each year.