The safety of deep brain stimulation lead placement on patients requiring anti-clotting therapies.

Abstract Background Limited studies exist to support the safety of performing neuromodulation surgeries in patients whose anticlotting medication has been held. Here, we assess the safety of performing deep brain stimulation (DBS) in this patient population. Methods All consecutive DBS patients who underwent lead and battery placement/revision at our institution between 2011 and 2020 were included in this IRB-approved prospective outcomes database. We retrospectively recorded adverse events occurring within 90 days of surgery. Results 226 patients who underwent 381 lead placements in 267 surgeries were included in this study. Of the 267 surgeries included in this study, 176 (66%) were performed on patients not on anticoagulants and 89 (33%) cases were on patients on 1 drug, and 2(0.7%) cases were on a patient taking 2 drugs. A total of 49 adverse events were seen. 13 occurred in patients taking anticoagulants. There was no difference in adverse event rate between patients on anticlotting medication and those not (χ2 (1)=1.523, p = 0.2171). No clot related sequalae occurred in any patient. Three hemorrhages occurred, all in patients not on anti-coagulants. Conclusion We found no increased risk of complications in patients routinely on anticlotting medication undergoing DBS lead placement. We show that our protocol was successful in balancing increased risks of bleeding and of thromboembolic events in this patient group.