{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:01:43Z","timestamp":1783612903318,"version":"3.55.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic subdural hematoma (CSDH) is a prevalent neurosurgical disorder with an increasing global incidence, particularly among the elderly. In recent years, minimally invasive burr-hole drainage, employing a small-diameter puncture needle in conjunction with a closed drainage system, has emerged as a preferred first-line intervention. This technique is associated with several clinical advantages, including lower recurrence rates, fewer postoperative complications, reduced mortality, and shorter operative durations and hospital stays. Despite these benefits, recurrence rates still range from 5 to 30%. One unresolved issue is the impact of preoperative antithrombotic therapy on recurrence and perioperative complications, which remains controversial and poorly defined in the current literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to optimize preoperative antithrombotic management in patients with CSDH through a retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective review was conducted on patients diagnosed with CSDH who underwent hard-channel puncture and drainage at Beijing Chaoyang Hospital, Capital Medical University, between December 2016 and March 2023. Patients were stratified into three groups according to their preoperative antithrombotic drug use and discontinuation status: (1) no antithrombotic use; (2) adequate discontinuation (\u22657\u202fdays prior to surgery); and (3) inadequate discontinuation (&amp;lt;7\u202fdays). The relationship between the duration of antithrombotic discontinuation and postoperative outcomes was analyzed to inform evidence-based perioperative management strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>The results showed no significant association between preoperative antithrombotic discontinuation and major clinical outcomes. However, insufficient discontinuation was associated with a significant prolongation of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insufficient preoperative antithrombotic discontinuation did not significantly affect major clinical outcomes in patients with CSDH undergoing hard-channel puncture drainage. However, it was associated with prolonged hospital stay. These findings support individualized preoperative antithrombotic management to optimize safety and efficacy while minimizing hospitalization duration.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1651267","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:12:10Z","timestamp":1758859930000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of preoperative antithrombotic discontinuation duration on clinical outcomes following hard channel surgery for chronic subdural hematoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Wen-Yu","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-ping","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2699","DOI":"10.1007\/s00701-022-05337-0","article-title":"The effect of antithrombotic therapy on the recurrence and outcome of chronic subdural hematoma after burr-hole craniostomy in a population-based cohort","volume":"164","author":"Kerttula","year":"2022","journal-title":"Acta Neurochir"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.jocn.2016.12.001","article-title":"Influence of antithrombotic agents on the recurrence of chronic subdural hematomas and the quest about the recommencement of antithrombotic agents: a 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chronic subdural hematoma","volume":"45","author":"Younsi","year":"2022","journal-title":"Neurosurg Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/02688697.2024.2333399","article-title":"Impact of antithrombotic agents on outcomes in patients requiring surgery for chronic subdural haematoma: a systematic review and meta-analysis","volume":"8","author":"Brannigan","year":"2024","journal-title":"Br J Neurosurg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3949\/ccjm.92a.24125","article-title":"2024 ACC\/AHA guideline on perioperative cardiovascular management before noncardiac surgery: what\u2019s new?","volume":"92","author":"Cohn","year":"2025","journal-title":"Cleve Clin J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s00701-024-06320-7","article-title":"Clinical outcome of subdural versus subgaleal drain after burr-hole drainage for chronic subdural hematoma","volume":"166","author":"Carter","year":"2024","journal-title":"Acta Neurochir"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"111233","DOI":"10.1016\/j.jocn.2025.111233","article-title":"YL-1 puncture needle-based minimally invasive drainage versus burr-hole drainage in chronic subdural hematoma: a meta-analysis of efficacy and safety","volume":"136","author":"Sun","year":"2025","journal-title":"J Clin Neurosci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.clineuro.2014.02.007","article-title":"Influence of antiplatelet therapy on postoperative recurrence of chronic subdural hematoma: a multicenter retrospective study in 719 patients","volume":"120","author":"Wada","year":"2014","journal-title":"Clin Neurol Neurosurg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e13972","DOI":"10.1097\/MD.0000000000013972","article-title":"The effects of antithrombotic drugs on the recurrence and mortality in patients with chronic subdural hematoma: a meta-analysis","volume":"98","author":"Wang","year":"2019","journal-title":"Medicine"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/s10143-017-0860-x","article-title":"Association between antithrombotic drug use before chronic subdural haematoma and outcome after drainage: a systematic review and meta-analysis","volume":"41","author":"Poon","year":"2018","journal-title":"Neurosurg Rev"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"106817","DOI":"10.1016\/j.clineuro.2021.106817","article-title":"Clinical characteristics and outcomes of chronic subdural hematoma in patients with a history of antiplatelet therapy","volume":"208","author":"Yu","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1089\/neu.2018.6080","article-title":"Influence of antiplatelet and anticoagulant drug use on outcomes after chronic subdural hematoma 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