Perioperative Thromboprophylaxis and Risk Factors for Thromboembolic Events in Meningioma Surgery: Findings From a Prospective Observational Study

Purpose This study aims to evaluate the effectiveness of different thromboprophylaxis regimens, certoparin, enoxaparin, and enoxaparin combined with intermittent pneumatic stockings (IPS), in reducing thromboembolic events (TE) after meningioma surgery, and to identify patient- and procedure-specific risk factors associated with TE. Methods A prospective cohort of 877 patients undergoing surgical resection of meningiomas was analyzed. Patients were stratified into three prophylaxis groups: certoparin, enoxaparin, and enoxaparin + IPS. Clinical variables such as age, sex, comorbidities, blood loss, surgery duration, tumor location and volume were assessed. Statistical analyses included chi-square tests and ANOVA. Results The overall incidence of TE was 3.1% (n = 27). TE rates were similar across groups: certoparin (3.5%), enoxaparin (3.5%), and enoxaparin + IPS (2.6%), with no statistically significant differences (p > .05). Chronic heart disease (p = .002) and surgery duration > 200 minutes (p = .004) were identified as independent risk factors for TE. Conclusion All three thromboprophylaxis regimens demonstrated comparable efficacy in preventing postoperative TE. Although not statistically significant, the combination of enoxaparin and IPS was associated with the lowest TE rate and no fatal events. These findings support risk-adapted prophylaxis strategies in patients with elevated procedural or cardiovascular risk.