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JOURNAL ARTICLE
Diana Andronic, Octavian Andronic, Elias Ammann, Edward Pravin, Rachael Cubberley
INTRODUCTION: There are currently different management guidelines for patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) that are on long-term anticoagulation. The timing of discontinuation and restarting the anticoagulation is challenging during the postoperative care, which often involves general practitioners and physiotherapists. METHODS: The systematic review followed the PRISMA guidelines and included 3 databases: PubMed/MEDLINE, EMBASE, and Web of Science Core Collection...
April 19, 2024: Family Practice
#2
JOURNAL ARTICLE
Omer Faruk Egerci, Aliekber Yapar, Fırat Dogruoz, Huseyin Selcuk, Ozkan Kose
The increasing frequency of total hip (THA) and knee arthroplasties (TKA) is marred by the rise in periprosthetic joint infections (PJIs) and surgical site infections (SSIs), with PJIs incurring costs over $1.62 billion as of 2020 and individual case management averaging $90,000. SSIs additionally burden the U.S. healthcare economy with billions in expenses annually. PJI prevalence in primary THA and TKA ranges from 0.5% to 2.4%, spiking to 20% in revisions and representing 25% of TKA revision causes. Projections estimate up to 270,000 annual PJI cases by 2030...
April 18, 2024: Archives of Orthopaedic and Trauma Surgery
#3
REVIEW
Xiaojing Huang, Pengqiang Du, Haipan Jia, Aifeng Wang, Ying Hua, Xuelan Liu, Kaiyuan Wu, Bin Li, Hongwei Zhao
Patient blood management (PBM) guidelines for patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) have increased during the past decade, and pharmacotherapy plays an important role in PBM. In the face of the undefined consistency in the methodologic quality and pharmacotherapy recommendations across multiple guidelines, this study exclusively evaluated methodologies of the related guideline development process, and compiled medication recommendations of PBM for cardiac surgery patients. PBM guidelines for cardiac surgery under CPB were searched through some mainstream literature and guideline databases from database establishment to May 15, 2023...
March 12, 2024: Journal of Cardiothoracic and Vascular Anesthesia
#4
JOURNAL ARTICLE
Trinithas Boyi, Rhys L Richmond, Darpan Kayastha, R Peter Manes, Ryan Rimmer
OBJECTIVES: Antithrombotic therapies, comprised of both anticoagulant and antiplatelet agents, are routinely paused prior to endoscopic sinus surgery (ESS) to reduce the risk of perioperative hemorrhage. At present, no clear guidelines exist to guide otolaryngologists on when to resume these agents after ESS. Our goal was to systematically review the existing literature related to this topic. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically queried the PubMed, Embase, Ovid, Web of Science, Cochrane, and CINAHL databases to identify publications reporting on antithrombotic and antiplatelet therapy in the context of ESS...
April 1, 2024: Annals of Otology, Rhinology, and Laryngology
#5
REVIEW
Qinan Yin, Lizhu Han, Yin Wang, Fengjiao Kang, Fengqun Cai, Liuyun Wu, Xingyue Zheng, Lian Li, Li E Dong, Limei Dong, Shuhong Liang, Min Chen, Yong Yang, Yuan Bian
Background: Thromboembolic disease is associated with a high rate of disability or death and gravely jeopardizes people's health and places considerable financial pressure on society. The primary treatment for thromboembolic illness is anticoagulant medication. Fondaparinux, a parenteral anticoagulant medicine, is still used but is confusing due to its disparate domestic and international indications and lack of knowledge about its usage. Its off-label drug usage in therapeutic settings and irrational drug use are also common...
2024: Frontiers in Pharmacology
#6
REVIEW
Yasmin Youssef, Anna K I M Dietrich, Annika Hättich
OBJECTIVES: Proximal femur fractures (PFF) are common injuries in elderly patients and can have considerable effects on their quality of life, morbidity, and mortality. Due to pre-existing comorbidities, the prevalence of anticoagulated patients is increasing. The right timing for surgery and perioperative anticoagulation treatment remains controversial. CONTENT: This overview aims to summarize current practices in the pre- and postoperative anticoagulation management and the recommended time to surgery in elderly patients with PFF...
December 2023: Innovative Surgical Sciences
#7
JOURNAL ARTICLE
M M Farhan-Alanie, R Chinweze, R Walker, W G P Eardley
INTRODUCTION: Due to their hypocoagulable state on presentation, anticoagulated patients with femoral fragility fractures typically experience delays to surgery. There are no large, multicentre studies previously carried out within the United Kingdom (UK) evaluating the impact of anticoagulant use in this patient population. This study aimed to evaluate the current epidemiology and compare the perioperative management of anticoagulated and non-anticoagulated femoral fragility fracture patients...
February 27, 2024: Injury
#8
REVIEW
Alfonso J Tafur, Geoffrey D Barnes, Vinai C Bhagirath, James Douketis
Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical challenge that demands input from multiple experts. Questions regarding the need for anticoagulation interruptions are frequent. Yet, due to layers of complexity involving analysis of anticoagulation indication, surgical risk, and anesthesia-associated bleeding risk as well as institutional practices, there is heterogeneity in how these interruptions are approached...
January 2024: TH Open: Companion Journal to Thrombosis and Haemostasis
#9
JOURNAL ARTICLE
John Eisenga, Jennie Hocking, Austin Kluis, J Michael DiMaio, Emily Shih, Justin Schaffer, David O Moore, William Ryan, Kelley Hutcheson
OBJECTIVES: Deep venous thrombosis (DVT) is a known surgical complication that can lead to pulmonary embolism with subsequent morbidity and mortality. The incidence of DVT following coronary artery bypass grafting is unclear. Prophylaxis regimens vary and some guidelines advocate against use of routine chemoprophylaxis in patients at low-moderate risk for venous thromboembolism. We utilized postoperative lower extremity venous ultrasound to determine the incidence of DVT following coronary artery bypass grafting in patients with low- to moderate-risk of venous thromboembolism receiving aggressive postoperative DVT prophylaxis...
February 2024: JTCVS open
#10
JOURNAL ARTICLE
Ugo Boggi, Emanuele Kauffmann, Niccolò Napoli, S George Barreto, Marc G Besselink, Giuseppe K Fusai, Thilo Hackert, Mohammad Abu Hilal, Giovanni Marchegiani, Roberto Salvia, Shailesh Shrikhande, Mark Truty, Jens Werner, Christopher Wolfgang, Elisa Bannone, Giovanni Capretti, Alice Cattelani, Alessandro Coppola, Alessandro Cucchetti, Davide De Sio, Armando Di Dato, Giovanna Di Meo, Claudio Fiorillo, Cesare Gianfaldoni, Michael Ginesini, Camila Hidalgo Salinas, Quirino Lai, Mario Miccoli, Roberto Montorsi, Michele Pagnanelli, Andrea Poli, Claudio Ricci, Francesco Sucameli, Domenico Tamburrino, Virginia Viti, Pietro F Addeo, Sergio Alfieri, Philippe Bachellier, Gianluca Baiocchi, Gianpaolo Balzano, Linda Barbarello, Alberto Brolese, Juli Busquets, Giovanni Butturini, Fabio Caniglia, Damiano Caputo, Riccardo Casadei, Xi Chunhua, Ettore Colangelo, Andrea Coratti, Francesca Costa, Francesco Crafa, Raffaele Dalla Valle, Luciano De Carlis, Roeland F de Wilde, Marco Del Chiaro, Fabrizio Di Benedetto, Pierluigi Di Sebastiano, Safi Domak, Melissa Hogg, Vyacheslav I Egorov, Giorgio Ercolani, Giuseppe Maria Ettorre, Massimo Falconi, Giovanni Ferrari, Alessandro Ferrero, Marco Filauro, Alessandro Giardino, Gian Luca Grazi, Salvatore Gruttaduaria, Jakob R Izbicki, Elio Jovine, Matthew Katz, Tobias Keck, Igor Khatkov, Gozo Kiguchi, David Kooby, Hauke Lang, Carlo Lombardo, Giuseppe Malleo, Marco Massani, Vincenzo Mazzaferro, Riccardo Memeo, Yi Miao, Kohei Mishima, Carlo Molino, Yuichi Nagakawa, Masafumi Nakamura, Bruno Nardo, Fabrizio Panaro, Claudio Pasquali, Vittorio Perrone, Elena Rangelova, Long Riu, Renato Romagnoli, Raffaele Romito, Edoardo Rosso, Richard Schulick, Ajith Siriwardena, Marcello Spampinato, Oliver Strobel, Mario Testini, Roberto Troisi, Faik G Uzunoglo, Roberto Valente, Luigi Veneroni, Alessandro Zerbi, Emilio Vicente, Fabio Vistoli, Marco Vivarelli, Go Wakabayashi, Giacomo Zanus, Amer Zureikat, Nicholas J Zyromski, Roberto Coppola, Vito D'Andrea, José Davide, Christos Dervenis, Isabella Frigerio, Kevin C Konlon, Fabrizio Michelassi, Marco Montorsi, William Nealon, Nazario Portolani, Donzília Sousa Silva, Giuseppe Bozzi, Viviana Ferrari, Maria G Trivella, John Cameron, Pierre-Alain Clavien, Horacio J Asbun
OBJECTIVE: The REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking...
February 26, 2024: Annals of Surgery
#11
REVIEW
Marc Maegele
PURPOSE: In the past, preinjury direct oral anticoagulant (DOAC) intake has led to delays in time to surgery (TTS) in patients with proximal femur fractures and delays in surgery have been associated with impaired outcomes. Although healthcare institutions/federal committees have set rules for treatment within 24 h of injury, comprehensive guidelines for the perioperative management of these patients, in particular when on preinjury DOACs, are still lacking. This contribution aims to summarize the current evidence on the safe time window for surgery in patients with proximal femur fractures on preinjury DOACs and to outline therapeutic options if emergency DOAC reversal becomes necessary...
February 24, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
#12
REVIEW
Jan Wienhold, Farahnaz Rayatdoost, Herbert Schöchl, Oliver Grottke
PURPOSE OF REVIEW: The advent of direct oral anticoagulants (DOACs) marks a significant milestone in anticoagulant treatment. However, DOACs can exacerbate bleeding, which is challenging for the treating clinician, especially when combined with traumatic injury. RECENT FINDINGS: In major bleeding associated with DOACs, rapid reversal of the anticoagulant effects is crucial. Recent observational and nonrandomized interventional trials have demonstrated the effectiveness of the specific antidotes andexanet alfa and idarucizumab as well as the unspecific prothrombin complex concentrates (PCCs) to counteract the anticoagulant effects of DOACs...
April 1, 2024: Current Opinion in Anaesthesiology
#13
JOURNAL ARTICLE
Devon T Brameier, Eric H Tischler, Taylor D Ottesen, Michael F McTague, Paul T Appleton, Mitchel B Harris, Michael J Weaver, Nishant Suneja
OBJECTIVES: To compare outcomes in patients on direct oral anticoagulants (DOACs) treated within 48 hours of last preoperative dose with those with surgical delays >48 hours. DESIGN: Retrospective cohort study. SETTING: Three academic Level 1 trauma centers. PATIENT SELECTION CRITERIA: Patients 65 years of age or older on DOACs before hip fracture treated between 2010 and 2018. Patients were excluded if last DOAC dose was >24 hours before admission, patient suffered from polytrauma, and/or delay to surgery was not attributed to DOAC...
March 1, 2024: Journal of Orthopaedic Trauma
#14
REVIEW
Maria P Ntalouka, Alexandros Brotis, Maria D Karagianni, Christina Arvaniti, Maria Mermiri, Maria Solou, Konstantinos Stamoulis, Metaxia Bareka, Konstantinos N Fountas, Eleni M Arnaoutoglou
PURPOSE: Perioperative management of patients medicated with antithrombotics requiring elective intracranial procedures is challenging. We ought to (1) identify the clinical practice guidelines (CPGs) and recommendations (CPRs) on perioperative management of antithrombotic agents in elective intracranial surgery and (2) assess their methodological quality and reporting clarity. METHODS: The study was conducted following the 2020 PRISMA guidelines for a systematic review and has been registered (PROSPERO, CRD42023415710)...
February 21, 2024: Acta Neurochirurgica
#15
REVIEW
Niklas Biermann, Juy Chi Chak, Anna Wiesmeier, Silvan M Klein, Marc Ruewe, Steffen Spoerl, Philipp Kruppa, Lukas Prantl, Alexandra M Anker
This systematic review addresses the crucial role of anticoagulation in microsurgical procedures, focusing on free flap reconstruction and replantation surgeries. The objective was to balance the prevention of thrombotic complications commonly leading to flap failure, with the risk of increased bleeding complications associated with anticoagulant use. A meticulous PubMed literature search following Evidence-Based-Practice principles yielded 79 relevant articles, including both clinical and animal studies. The full-texts were carefully reviewed and evaluated by the modified Coleman methodology score...
January 3, 2024: Life
#16
JOURNAL ARTICLE
A Pedicelli, I Valente, A Alexandre, L Scarcia, R Gigli, Francesco Signorelli, Massimiliano Visocchi
Chronic subdural hematoma (cSDH) is defined as a subdural collection of blood on CT imaging that tends to persist and gradually increase in volume over time, with components that are hypodense or isodense compared to the brain. There are no proven guidelines for the management of patients with cSDH. Surgical approaches included burr hole, twist drill hole, and craniotomy-based evacuations. Outcomes after surgical removal is generally favorable, but cSDH tends to recur after the initial evacuation.Middle meningeal artery (MMA) embolization has been gaining increasing popularity among the treatments of cSDH...
2023: Acta Neurochirurgica. Supplement
#17
JOURNAL ARTICLE
Chao Han, Xiaodan Li, Xiang Sun, Zhe Han, Jianan Liu, Weiwei He, Qiang Dong
OBJECTIVE: To review the research progress of rapid surgery for hip fracture in elderly patients. METHODS: The published studies, expert consensus, and guidelines at home and abroad were systematically summarized from the aspects of the characteristics of aging population, the benefits of rapid surgery, the disadvantages of delayed surgery, and the recommendations of current guidelines, so as to further guide clinical practice. RESULTS: Hip fracture is a common fracture type in the elderly population...
December 15, 2023: Chinese Journal of Reparative and Reconstructive Surgery
#18
JOURNAL ARTICLE
Young Hwan Kim, Jennifer Pavone, Vivian A B Wasmuht-Perroud, Robert W Frare, Paul R Baker
About 6.2 million adults in the United States suffer from heart failure (HF). For patients with advanced HF refractory to medical therapy, an orthotopic heart transplant or a ventricular assist device (VAD) is the only long-term survival option. The most commonly used form of these devices is the left VAD (LVAD), implanted to support the left ventricle. As many as 2754 LVADs were implanted annually between 2006 and 2015, allowing recipients to maintain a relatively normal lifestyle, including both elective and emergency dental care in the ambulatory setting...
2024: General Dentistry
#19
JOURNAL ARTICLE
Qin Tan, Lu Zhou, Yihan Lu, Weifeng Huang
BACKGROUND: Venous thromboembolism (VTE) remains a priority challenge among orthopedic trauma patients. It is crucial to further improve the prophylaxis against VTE in routine orthopedic treatment. This study aims to compare the efficacy of two low molecular weight heparin (LMWH) regimens and additional intermittent pneumatic compression in preventing VTE among orthopedic trauma patients. METHODS AND ANALYSIS: This is a cluster-randomized crossover clinical study conducted in four hospitals in Shanghai from December 2019 to December 2023...
December 19, 2023: Trials
#20
Kevin R Bainey, Guillaume Marquis-Gravel, Emilie Belley-Côté, Ricky D Turgeon, Margaret L Ackman, Hazal E Babadagli, David Bewick, Laurie-Anne Boivin-Proulx, Warren J Cantor, Stephen E Fremes, Michelle M Graham, Marie Lordkipanidzé, Mina Madan, Samer Mansour, Shamir R Mehta, Brian J Potter, Jay Shavadia, Derek F So, Jean-François Tanguay, Robert C Welsh, Andrew T Yan, Akshay Bagai, Rodrigo Bagur, Claudia Bucci, Basem Elbarouni, Carol Geller, Andrea Lavoie, Patrick Lawler, Shuangbo Liu, John Mancini, Graham C Wong
Antiplatelet therapy (APT) is the foundation of treatment and prevention of atherothrombotic events in patients with atherosclerotic cardiovascular disease. Selecting the optimal APT strategies to reduce major adverse cardiovascular events, while balancing bleeding risk, requires ongoing review of clinical trials. Appended, the focused update of the Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology guidelines for the use of APT provides recommendations on the following topics: (1) use of acetylsalicylic acid in primary prevention of atherosclerotic cardiovascular disease; (2) dual APT (DAPT) duration after percutaneous coronary intervention (PCI) in patients at high bleeding risk; (3) potent DAPT (P2Y12 inhibitor) choice in patients who present with an acute coronary syndrome (ACS) and possible DAPT de-escalation strategies after PCI; (4) choice and duration of DAPT in ACS patients who are medically treated without revascularization; (5) pretreatment with DAPT (P2Y12 inhibitor) before elective or nonelective coronary angiography; (6) perioperative and longer-term APT management in patients who require coronary artery bypass grafting surgery; and (7) use of APT in patients with atrial fibrillation who require oral anticoagulation after PCI or medically managed ACS...
October 29, 2023: Canadian Journal of Cardiology
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