Incidence of Intracranial Hemorrhage in Glioma Patients With Venous Thromboembolism Converted From LMWH to Apixaban

Inclusion Criteria:

* Patients must be 18 years of age or older;
* Patients must have had a pathologically confirmed supra-tentorial primary brain tumor
* Patients must have history of deep venous thrombosis (DVT) and/or pulmonary embolism (PE)
* Patients must have been treated with low molecule weight heparin for ≥ 5 days
* Patients must be able to provide written informed consent
* Patients must have non contrast CT that is negative for intra-cranial bleed at least 5 days post initiation of LMWH and prior to initiation (within 7 days) of Apixaban
* Must be decision by patient and his physician to convert to Apixaban

Exclusion Criteria:

* Patients with a plan less than 6 months of anticoagulation for most recent DVT or PE
* Patients with allergic reaction to Apixaban
* Patients with active bleeding or high risk for bleeding contraindicating treatment with LMWH
* Patients with planned surgery in the next 2 weeks
* Patients previously treated with Apixaban
* Patients requiring Acetylsalicylic Acid (ASA) greater than165 mg/day at enrollment
* Patients requiring dual anti-platelet therapy (ASA plus clopidogrel or ASA plus ticlopidine) at enrollment.
* Subjects with transition for dual anti-platelet therapy or monotherapy prior to enrollment will be eligible for the study
* Patients who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness
* Any condition, which in the opinion of the investigator, would put the subject at an unacceptable risk from participating in the study
* Any other medical, social, logistical, or psychological reason, which in the opinion of the investigator, would preclude compliance with, or successful completion of, the study protocol
* Known active and clinically significant liver disease (e.g., hepatorenal syndrome)
* Known bacterial endocarditis
* Know uncontrolled hypertension: systolic blood pressure greater than 160 mm Hg or diastolic blood pressure greater than 100 mm Hg; (subjects who have a transient, higher blood pressure elevation associated with acute PE \[upper limit: systolic blood pressure 200 mm Hg or diastolic blood pressure 100 mm Hg\] may enter the study;) elevated blood pressure that is persistent 1 - 2 days after the index DVT or PE should be treated according to local guidelines