Symptomatic venous thromboembolism after transsphenoidal surgery in Cushing’s disease: incidence and risk factors
Authors' conclusion
CD patients are at higher risk for early post-TSS VTE, including symptomatic PE. Identifying high-risk patients and implementing perioperative prophylaxis in the immediate postoperative period may help mitigate these complications. Further research is needed to optimize prevention strategies in this population.
Study context
- Population
- Patients with Cushing's Disease (CD) or non-functioning pituitary adenomas (NFPAs) who underwent transsphenoidal surgery (TSS) at Massachusetts General Hospital, 2005–2019
- Participants
- 315 vs 559
- Exposure
- CD vs NFPA patients undergoing TSS
- CDn = 315
- NFPAn = 559reference
- Outcome
- Incidence of VTE post-TSS, confirmed by imaging after clinical suspicion; early VTE defined as within 7 days
- Follow-up
- 90 days
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Overall post-TSS VTE
P = 0.18
Observational data: associations, not effects.
Further findings
Events
| Outcome | CD | NFPA | P value |
|---|---|---|---|
| Early VTE (within 1 week) · 7 days | 5 | 0 | P = 0.006 |
- Early venous thromboembolism (VTE) (within 1 week) — Early deep venous thrombosis (DVT) with history of prior DVT
- 2 of 3
Early VTE (within 1 week) · 7 days
- CD patients presenting with PE on postoperative day (POD) 1 or 2
Risk factors for post-TSS VTE in CD (VTE vs no VTE), univariate analysis
- Higher rate of prior VTE history
- P = 0.003
- Higher rate of hypertension
- P = 0.038
- Larger tumor size
- P = 0.045
- Univariate analysis
Original publication
Symptomatic venous thromboembolism after transsphenoidal surgery in Cushing’s disease: incidence and risk factors. Pituitary. Published 26 May 2025. doi:10.
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