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Thromboembolism guidelines

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https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#1
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#2
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thromboembolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28329309/changes-in-oral-anticoagulation-for-elective-cardioversion-results-from-a-european-cardioversion-registry
#3
Judit Papp, Endre Zima, Ramon Bover, Rasa Karaliute, Andrea Rossi, Catherine Szymanski, Rossella Troccoli, Jonas Schneider, Morten Wang Fagerland, A John Camm, Dan Atar
Aims: In patients with atrial fibrillation (AF) pharmacological or electrical cardioversion may be performed to restore sinus rhythm. The procedure is associated with an increased risk of thromboembolic events, which can be significantly reduced by adequate anticoagulation (OAC). Our aim was to create a partly prospective, partly retrospective cardioversion registry, particularly focusing on OAC strategies in different European countries, and on emerging choice of OAC over time. Methods: From September 2014 to October 2015, cardioversions due to AF performed in six European city hospitals in five European countries (Hungary: Budapest-1 and -2; Italy: Bari and Pisa; France: Amiens; Spain: Madrid; and Lithuania: Kaunas) were recorded in the registry...
March 17, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28298388/pulmonary-endarterectomy-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#4
REVIEW
David Jenkins, Michael Madani, Elie Fadel, Andrea Maria D'Armini, Eckhard Mayer
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension, resulting from fibrotic transformation of pulmonary artery clots causing chronic obstruction in macroscopic pulmonary arteries and associated vascular remodelling in the microvasculature.Pulmonary endarterectomy (PEA) offers the best chance of symptomatic and prognostic improvement in eligible patients; in expert centres, it has excellent results. Current in-hospital mortality rates are <5% and survival is >90% at 1 year and >70% at 10 years...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28297002/use-of-computerized-clinical-decision-support-systems-to-prevent-venous-thromboembolism-in-surgical-patients-a-systematic-review-and-meta-analysis
#5
Zachary M Borab, Michael A Lanni, Michael G Tecce, Christopher J Pannucci, John P Fischer
Importance: Health care professionals do not adequately stratify risk or provide prophylaxis for venous thromboembolism (VTE) among surgical patients. Computerized clinical decision support systems (CCDSSs) have been implemented to assist clinicians and improve prophylaxis for VTE. Objective: To evaluate the effect of implementing CCDSSs on the ordering of VTE prophylaxis and the rates of VTE. Data Sources: PubMed, MEDLINE via OVID, EMBASE via OVID, Scopus, Cochrane CENTRAL Register of Controlled Trials, and clinicaltrials...
March 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#6
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28274053/dentists-knowledge-attitude-and-practice-in-treating-patients-taking-oral-antithrombotic-medications-a-survey
#7
Ravindran Chinnaswami, Ritvi K Bagadia, Anusha Mohan, Eswar Kandaswamy, Deepak Chandrasekaran
INTRODUCTION: India lists high on patients suffering from diabetes, hypertension, stroke and myocardial infarction. Hence, a large proportion of the population is on long term Oral Antithrombotic Medications (OAM). Though several guidelines exist on dental management of these patients, previous surveys have shown variation among the dentists. AIM: The purpose of this study was to assess the knowledge, attitude and practice of dentists in Chennai, India, towards dental management of patients taking OAM using a questionnaire survey...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28272736/reintroduction-of-anti-thrombotic-therapy-after-a-gastrointestinal-haemorrhage-if-and-when
#8
REVIEW
Martin J Scott, Andrew Veitch, Jecko Thachil
Gastrointestinal haemorrhage is a common clinical scenario and, in those using antithrombotic agents, the risk is significantly increased. Management of these patients, in terms of initial resuscitation is well established and numerous guidelines exist in this area. However, few studies have addressed the subsequent dilemma of if and when antithrombotic agents should be reintroduced. Consequently, practice is variable and not necessarily evidenced-based. Overall, for patients that are either anticoagulated or using antiplatelet drugs for secondary prophylaxis, there is a clear benefit to restarting these agents...
March 8, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28265128/how-we-manage-pediatric-deep-venous-thrombosis
#9
REVIEW
Marisol Betensky, Mark A Bittles, Paul Colombani, Neil A Goldenberg
Over the past two decades, the incidence and recognition of venous thromboembolism (VTE) in children has significantly increased, likely as a result of improvements in the medical care of critically ill patients and increased awareness of thrombotic complications among medical providers. Current recommendations for the management of VTE in children are largely based on data from pediatric registries and observational studies, or extrapolated from adult data. The scarcity of high-quality evidence-based recommendations has resulted in marked variations in the management of pediatric VTE among providers...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28264198/risk-assessment-scores-for-cancer-associated-venous-thromboembolic-disease
#10
Dana Angelini, Alok A Khorana
Current guidelines recommend that patients with cancer be assessed for venous thromboembolism (VTE) risk at the time of chemotherapy initiation and periodically thereafter. Rates of VTE vary substantially among cancer patients. Multiple clinical factors contribute to VTE risk, including the primary site of cancer, extent of disease, interventions including major surgery, hospitalization, and systemic therapy. However, risk of VTE cannot reliably be predicted based on a single risk factor or biomarker. Within the last decade, risk assessment scores have been developed in cancer patients to more reliably predict thromboembolic events...
March 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#11
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28257391/evaluation-of-guidelines-for-injured-children-at-high-risk-for-vte-a-prospective-observational-study
#12
Rachel M Landisch, Sheila J Hanson, Laura D Cassidy, Kristin Braun, Rowena C Punzalan, David M Gourlay
BACKGROUND: Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE prophylaxis has not been standardized in injured pediatric patients. Our institution identified factors potentially associated with a high risk of VTE in critically injured children that led to prospective implementation of VTE prophylaxis guidelines. We hypothesize the guidelines are accurate in predicting children at risk for VTE...
March 2, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28255434/efficacy-and-safety-of-the-target-specific-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation-the-real-life-evidence
#13
REVIEW
Vincenzo Russo, Anna Rago, Riccardo Proietti, Federica Di Meo, Andrea Antonio Papa, Paolo Calabrò, Antonio D'Onofrio, Gerardo Nigro, Ahmed AlTurki
The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF)...
February 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28255372/upper-gastrointestinal-endoscopy-in-emergency-setting-for-patients-receiving-oral-anticoagulants-practice-updates
#14
REVIEW
R Oprita, B Oprita, B Diaconescu, M R Bratu, D Berceanu
Anticoagulants are frequently used medications in diverse cardiovascular diseases. Their uses highly increase the risk of bleeding from upper and lower gastrointestinal sources, whether there is a classic vitamin K antagonist or a novel oral anticoagulant. Their interruption can promote procoagulation status with different thromboembolic accidents. Discontinuation of oral anticoagulants before the elective procedures is standardized but there are no guidelines for managing bleeding lesions of upper gastrointestinal tract concomitant with anticoagulation...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28250479/consensus-statement-on-anaesthesia-for-day-care-surgeries
#15
REVIEW
Satish Kulkarni, S S Harsoor, M Chandrasekar, S Bala Bhaskar, Jitendra Bapat, Edakeparavan Keloth Ramdas, Umesh Kumar Valecha, Amol Shashikumar Pradhan, Adarsh Chandra Swami
The primary aim of day-care surgery units is to allow for early recovery of the patients so that they can return to their familiar 'home' environment; the management hence should be focused towards achieving these ends. The benefits could include a possible reduction in the risk of thromboembolism and hospital-acquired infections. Furthermore, day-care surgery is believed to reduce the average unit cost of treatment by up to 70% as compared to inpatient surgery. With more than 20% of the world's disease burden, India only has 6% of the world's hospital beds...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28249199/venous-thrombosis-in-children-and-adolescents-with-hodgkin-lymphoma-in-sweden
#16
A Schönning, J Karlén, T Frisk, M Heyman, J E Svahn, I Øra, L Kawan, B-M Holmqvist, C Björklund, A Harila-Saari, S Ranta
INTRODUCTION: Pediatric patients with Hodgkin lymphoma (HL) have several risk factors for venous thromboembolism (VTE). Although these patients are occasionally treated with thromboprophylaxis, no guidelines are implemented in Sweden. Scarce data from adult patients indicate an increased risk of VTE, but pediatric data is largely missing. Given the favorable overall survival of HL, there should reasonably be more focus on preventing complications. MATERIALS AND METHODS: We conducted a retrospective cohort study, including all patients registered in the Childhood Cancer Registry under the age of 18years diagnosed with HL between January 2005 and December 2015 in Sweden...
February 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28243988/fotrocan-delphi-consensus-statement-regarding-the-prevention-and-treatment-of-cancer-associated-thrombosis-in-areas-of-uncertainty-and-low-quality-of-evidence
#17
P Jimenez-Fonseca, A Carmona-Bayonas, C Calderon, J Fontcuberta Boj, C Font, R Lecumberri, M Monreal, A J Muñoz Martín, R Otero, A Rubio, P Ruiz-Artacho, C Suarez Fernández, E Colome, P Pérez Segura
INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method...
February 27, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28236004/-edoxaban-for-stroke-prevention-in-atrial-fibrillation-and-treatment-of-venous-thromboembolism-an-expert-position-paper
#18
REVIEW
Thomas W Weiss, Miklos Rohla, Benjamin Dieplinger, Hans Domanovits, Dietmar Fries, Milan R Vosko, Thomas Gary, Cihan Ay
Edoxaban is the most recent available representative of the Non-Vitamin K antagonist oral anticoagulants (NOAC). The approval was based on the largest phase III trials of NOACs for stroke prevention in patients with non-valvular atrial fibrillation (AF, ENGAGE-AF), and for the treatment of venous thromboembolism (VTE, HOKUSAI-VTE). In both trials, edoxaban was associated with similar efficacy and a significant reduction in bleeding events with respect to the pre-defined primary safety endpoints, as compared to warfarin...
February 24, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28229295/benchmarking-of-venous-thromboembolism-prophylaxis-practice-with-ent-uk-guidelines
#19
Ali S Al-Qahtani
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT...
February 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28228120/findings-of-transoesophageal-echocardiogram-in-appropriately-anticoagulated-patients-with-persistent-atrial-fibrillation-prior-to-planned-cardioversion
#20
Jūratė Barysienė, Aistė Žebrauskaitė, Dovilė Petrikonytė, Germanas Marinskis, Sigita Aidietienė, Audrius Aidietis
BACKGROUND: To evaluate a diagnostic value of transoesophageal echocardiogram (TEE) in appropriately anticoagulated patients with a non-valvular atrial fibrillation (AF) and to establish possible additional indications for TEE; to evaluate the incidence of left atrial (LA) thrombi in appropriately anticoagulated patients in daily clinical practice. METHODS: This retrospective study analyses data of 432 patients who had been anticoagulated by means of oral anticoagulants (OACs) prior to planned cardioversion during the period from 2012 to 2015...
February 23, 2017: BMC Cardiovascular Disorders
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