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Brief Report

Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery

1
Department of Neurosurgery, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
2
Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: O-ki Kwon
Neurol. Int. 2021, 13(2), 202-206; https://doi.org/10.3390/neurolint13020021
Received: 11 April 2021 / Revised: 5 May 2021 / Accepted: 8 May 2021 / Published: 13 May 2021
Background: An outbreak of African swine fever (ASF) in China in 2020 has led to an unprecedented shortage of nadroparin. Most patients, especially those kept in hospital for surgery, are currently treated with prophylactic anticoagulation (AC). In search of alternatives for nadroparin (fraxiparine), we found no sufficient data on alternatives for neurosurgical patients, such as tinzaparin of European origin. We compared nadroparin and tinzaparin concerning adverse events (bleeding versus thromboembolic events) in neurosurgical patients. Methods: Between 2012 and 2018, 517 neurosurgical patients with benign and malignant brain tumors as well as 297 patients with subarachnoid hemorrhage (SAH) were treated in the Department of Neurosurgery, University Hospital Leipzig, receiving prophylactic anticoagulation within 48 h. In 2015, prophylactic anticoagulation was switched from nadroparin to tinzaparin throughout the university hospital. In a retrospective manner, the frequency and occurrence of adverse events (rebleeding and thromboembolic events) in connection with the substance used were analyzed. Statistical analysis was performed using Fisher’s exact test and the chi-squared test. Results: Rebleeding rates were similar in both nadroparin and tinzaparin cohorts in patients being treated for meningioma, glioma, and SAH combined (8.8% vs. 10.3%). Accordingly, the rates of overall thromboembolic events were not significantly different (5.5% vs. 4.3%). The severity of rebleeding did not vary. There was no significant difference among subgroups when compared for deep vein thrombosis (DVT) or pulmonary embolism (PE). Conclusion: In this retrospective study, tinzaparin seems to be a safe alternative to nadroparin for AC in patients undergoing brain tumor surgery or suffering from SAH. View Full-Text
Keywords: tinzaparin; African swine fever; heparin shortage; nadroparin; neurosurgery; perioperative anticoagulation tinzaparin; African swine fever; heparin shortage; nadroparin; neurosurgery; perioperative anticoagulation
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MDPI and ACS Style

Wilhelmy, F.; Hantsche, A.; Gaier, M.; Kasper, J.; Fehrenbach, M.K.; Oesemann, R.; Meixensberger, J.; Lindner, D. Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery. Neurol. Int. 2021, 13, 202-206. https://doi.org/10.3390/neurolint13020021

AMA Style

Wilhelmy F, Hantsche A, Gaier M, Kasper J, Fehrenbach MK, Oesemann R, Meixensberger J, Lindner D. Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery. Neurology International. 2021; 13(2):202-206. https://doi.org/10.3390/neurolint13020021

Chicago/Turabian Style

Wilhelmy, Florian, Annika Hantsche, Michael Gaier, Johannes Kasper, Michael K. Fehrenbach, Rene Oesemann, Jürgen Meixensberger, and Dirk Lindner. 2021. "Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery" Neurology International 13, no. 2: 202-206. https://doi.org/10.3390/neurolint13020021

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