Article Text

other Versions

PDF
Original research
Heparin dosing is associated with diffusion weighted imaging lesion load following aneurysm coiling
  1. Mary Jane Lim Fat1,
  2. Mohammed Al-Hazzaa2,
  3. Miguel Bussière2,3,
  4. Marlise P dos Santos3,
  5. Howard Lesiuk3,
  6. Cheemun Lum3
  1. 1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Division of Neurology, The Ottawa Hospital, Ottawa, Ontario, Canada
  3. 3Division of Interventional and Diagnostic Neuroradiology, The Ottawa Hospital, Ottawa, Ontario, Canada
  1. Correspondence to Cheemun Lum, Diagnostic Imaging, The Ottawa Hospital General Campus, Room S2, Box 232, 501 Smyth road, Ottawa, Ontario, K1H 8L6 Canada; chlum{at}ottawahospital.on.ca

Abstract

Background and purpose Diffusion weighted imaging (DWI) may be used to evaluate post-coiling ischemia. Heparinization protocols for cerebral aneurysm coiling procedures differ among operators and centers, with little literature surrounding its effect on DWI lesions. The goal of this study was to determine which factors, including heparinization protocols, may affect DWI lesion load post-coiling.

Materials and methods A review of 135 coiling procedures over 5 years at our centre was performed. Procedural data including length of procedure, number of coils used, stent or balloon assistance and operators were collected. Procedures were either assigned as using a bolus dose (>2000 U at any one time) or small aliquots of heparin (≤2000 U). Postprocedure DWI was reviewed and lesions were classified as small (< 5mm), medium (5–10 mm) or large (>10 mm). The cases were then classified into group 1 (≤5 small lesions) or group 2 (>5 small lesions or ≥1 medium or large lesion). Multivariate regression of the procedural variables for the two groups was calculated. A p value of <0.05 was considered significant.

Results There were 78 procedures in group 1 and 57 procedures in group 2. Patients who received small aliquots (n=37) versus boluses of heparin (n=98) intraprocedurally had significantly greater frequency and size of DWI lesions (p=0.03). None of the other procedural variables was found to impact on lesion load.

Conclusions More substantial DWI lesions were associated with small aliquots of heparin dosage compared with bolus doses. Heparin boluses should be preferentially administered during aneurysm coiling.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Ottawa Hospital Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data from the study are only available to the authors of the paper.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.