Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-26T21:37:39.957Z Has data issue: false hasContentIssue false
  • English
  • Français

Intracranial hemorrhage during GliaSite RTS manipulation in an anticoagulated patient

Published online by Cambridge University Press:  01 March 2007

David E. Gerber ,
Stuart A. Grossman ,
Timothy A. Chan  and
Lawrence Kleinberg
David E. Gerber
Affiliation:
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Stuart A. Grossman*
Affiliation:
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA Department of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA Department of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Timothy A. Chan
Affiliation:
Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Lawrence Kleinberg
Affiliation:
Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
*
Correspondence to: Stuart A. Grossman, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, CRB II, suite 1M-16, Baltimore, MD 21231, USA. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The GliaSite radiation therapy system (RTS) is an implantable balloon brachytherapy applicator used to deliver iodine-125 in the treatment of recurrent high-grade gliomas. Patients generally tolerate the procedure well, with only rare reports of adverse events such as wound infection, meningitis, and symptomatic radiation necrosis. Hemorrhagic complications have not been reported. We present a case report describing intracranial hemorrhage during GliaSite manipulation in a patient receiving long-term anticoagulation for a previously diagnosed pulmonary embolism. The GliaSite RTS and the management of venous thromboembolism in patients with brain tumors are reviewed. These events suggest that normalizing coagulation status during GliaSite balloon inflation and deflation should be considered.

Keywords

Glioblastoma multiformeVenous thromboembolismAnticoagulationIntracranial hemorrhageGilaSite RTSBrachytherapy
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 1 , March 2007 , pp. 53 - 57
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tatter, SB, Shaw, EG, Rosenblum, ML, et al. . An inflatable balloon catheter and liquid 125-I radiation source (GliaSite Radiation Therapy System) for treatment of recurrent malignant glioma: multicenter safety and feasibility trial. J Neurosurg 2003;99(2):297–303.CrossRefGoogle Scholar
Chan, TA, Weingart, JD, Parisi, M, et al. . Treatment of recurrent glioblastoma multiforme with GliaSite brachytherapy. Int J Radiat Oncol Biol Phys 2005;62(4):1133–1139.CrossRefGoogle ScholarPubMed
Lee, SW, Fraass, BA, Marsh, LH, et al. . Patterns of failure following high-dose 3-D conformal radiotherapy for high-grade astrocytomas: a quantitative dosimetric study. Int J Radiat Oncol Biol Phys 1999;43(1):79–88.CrossRefGoogle ScholarPubMed
Sneed, PK, Gutin, PH, Larson, DA, et al. . Patterns of recurrence of glioblastoma multiforme after external irradiation followed by implant boost. Int J Radiat Oncol Biol Phys 1994;29(4):719–727.CrossRefGoogle ScholarPubMed
Ruff, RL, Posner, JB. Incidence and treatment of peripheral venous thrombosis in patients with glioma. Ann Neurol 1983;13(3):334–336.CrossRefGoogle ScholarPubMed
Levin, JM, Schiff, D, Loeffler, JS, Fine, HA, Black, PM, Wen, PY. Complications of therapy for venous thromboembolic disease in patients with brain tumors. Neurology 1993;43(6):1111–1114.CrossRefGoogle ScholarPubMed
Gerber, DE, Grossman, SA, Streiff, MB. Management of venous thromboembolism in patients with primary and metastatic brain tumors. J Clin Oncol 2006;24(8):1310–1318.Google Scholar
Dickinson, LD, Miller, LD, Patel, CP, Gupta, SK. Enoxaparin increases the incidence of postoperative intracranial hemorrhage when initiated preoperatively for deep venous thrombosis prophylaxis in patients with brain tumors. Neurosurgery 1998;43(5):1074–1081.CrossRefGoogle ScholarPubMed
Sandberg, DI, Bilsky, MH, Souweidane, MM, Bzdil, J, Gutin, PH. Ommaya reservoirs for the treatment of leptomeningeal metastases. Neurosurgery 2000;47(1):49,54; discussion 54–55.Google ScholarPubMed
Stubbs, JB, Strickland, AD, Frank, RK, Simon, J, McMillan, K, Williams, JA. Biodistribution and dosimetry of an aqueous solution containing sodium 3-(125I)iodo- 4-hydroxybenzenesulfonate (Iotrex) for brachytherapy of resected malignant brain tumors. Cancer Biother Radiopharm 2000;15(6):645–656.Google Scholar