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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
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JOURNAL ARTICLE
C Weimar, J Beyer-Westendorf, F O Bohmann, G Hahn, S Halimeh, S Holzhauer, C Kalka, M Knoflach, H-C Koennecke, F Masuhr, M-L Mono, U Nowak-Göttl, E Scherret, M Schlamann, B Linnemann
Over the last years, new evidence has accumulated on multiple aspects of diagnosis and management of cerebral venous and dural sinus thrombosis (CVT) including identification of new risk factors, studies on interventional treatment as well as treatment with direct oral anticoagulants. Based on the GRADE questions of the European Stroke Organization guideline on this topic, the new German guideline on CVT is a consensus between expert representatives of Austria, Germany and Switzerland. New recommendations include:• CVT occurring in the first weeks after SARS-CoV-2 vaccination with vector vaccines may be associated with severe thrombocytopenia, indicating the presence of a prothrombotic immunogenic cause (Vaccine-induced immune thrombotic thrombocytopenia; VITT)...
April 19, 2024: Neurological research and practice
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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
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EDITORIAL
Stephanie Carlin, John Eikelboom
No abstract text is available yet for this article.
January 10, 2024: Canadian Journal of Cardiology
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REVIEW
Theodore E Warkentin
Intermittent hemodialysis (HD) is almost invariably performed with heparin, and thus HD patients are at risk of developing the immune-mediated adverse effect heparin-induced thrombocytopenia (HIT), caused by anti-platelet factor 4/heparin IgG, which strongly activates platelets. HIT patients develop hypercoagulability with greatly increased risk of thrombosis, both venous and arterial. Certain HIT-associated complications are more likely to develop among HD patients, including hemofilter thrombosis despite heparin, intravascular catheter and/or arteriovenous fistula-associated thrombosis, post-heparin bolus anaphylactoid/anaphylactic reactions, and thrombotic stroke and acute limb artery thrombosis (reflecting the high frequency of underlying arteriopathy in many patients with renal failure)...
January 8, 2024: Seminars in Nephrology
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JOURNAL ARTICLE
Carlos Moliner-Abós, Blanca Albertí-Vall, Xavier Millan-Álvarez, Pol Camps-Renom, Marina Guasch-Jiménez, Lluís Asmarats-Serra, Álvaro Lambea-Gil, Garbiñe Ezcurra-Díaz, Dabit Arzamendi-Aizpurua, Joan Martí-Fàbregas
BACKGROUND: Patients with atrial fibrillation (AF) and intracerebral hemorrhage (ICH) are at high risk of ischemic and recurrent bleeding events. Therefore, the decision of restarting or avoiding anticoagulation is challenging. Left atrial appendage occlusion (LAAO) is an alternative for these patients. However, few data are available about safety of early LAAO and factors associated with ischemic stroke and ICH recurrence. METHODS: A unicentric, observational, retrospective study including all patients with AF and a previous ICH who underwent LAAO...
December 7, 2023: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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Xin Yu Yang, Annie Le-Nguyen, Fernando Alvarez, Zhi Xia Rong, Daniel Borsuk, Nelson Piché, Michel Lallier, Mona Beaunoyer
INTRODUCTION: In pediatric patients with Budd-Chiari syndrome (BCS), living donor liver transplantation (LDLT) raises substantial challenges regarding IVC reconstruction. CASE PRESENTATION: We present a case of an 8-year-old girl with BCS caused by myeloproliferative syndrome with JAK2 V617F mutation. She had a complete thrombosis of the inferior vena cava (IVC) with multiple collaterals, developing a Budd-Chiari syndrome. She underwent LDLT with IVC reconstruction with a cryopreserved pulmonary vein graft obtained from a provincial biobank...
December 6, 2023: Pediatric Transplantation
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JOURNAL ARTICLE
Eiichi Suehiro, Hideyuki Ishihara, Yohei Kogeichi, Tsunenori Ozawa, Koichi Haraguchi, Masaru Honda, Yumie Honda, Makoto Inaba, Ryusuke Kabeya, Naoaki Kanda, Kenta Koketsu, Nobukuni Murakami, Hidetoshi Nakamoto, Kotaro Oshio, Kuniyasu Saigusa, Takashi Shuto, Shuichi Sugiyama, Kenji Suzuyama, Tsuguaki Terashima, Mitsuharu Tsuura, Mitsutoshi Nakada, Hitoshi Kobata, Toshio Higashi, Nobuyuki Sakai, Michiyasu Suzuki
Use of anticoagulants is increasing with the aging of societies. The safe first-line drug is likely to be a direct oral anticoagulant (DOAC), but outcomes of treatment of traumatic brain injury (TBI) with anticoagulants are uncertain. Therefore, we examined the clinical effect of idarucizumab as reversal therapy in elderly patients with TBI who were treated with dabigatran. A retrospective multi-center observational study was performed in patients ≥65 years of age who developed acute traumatic subdural hematoma during treatment with dabigatran and underwent reversal therapy with idarucizumab...
2023: Neurotrauma reports
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JOURNAL ARTICLE
Gennaro Martucci, Marco Giani, Matthieu Schmidt, Kenichi Tanaka, Ali Tabatabai, Fabio Tuzzolino, Cara Agerstrand, Jordi Riera, Raj Ramanan, Giacomo Grasselli, Ali Ait Hssain, Whitney D Gannon, Sara Buabbas, Vojka Gorjup, Brian Trethowan, Monica Rizzo, Vito Fanelli, Kyeongman Jeon, Gennaro De Pascale, Alain Combes, Marco V Ranieri, Thibault Duburcq, Giuseppe Foti, Juan I Chico, Martin Balik, Lars Mikael Broman, Peter Schellongowski, Hergen Buscher, Roberto Lorusso, Daniel Brodie, Antonio Arcadipane
Rationale: Definitive guidelines for anticoagulation management during veno-venous extracorporeal membrane oxygenation (VV ECMO) are lacking, whereas bleeding complications continue to pose major challenges. Objectives: To describe anticoagulation modalities and bleeding events in adults receiving VV ECMO. Methods: This was an international prospective observational study in 41 centers, from December 2018 to February 2021. Anticoagulation was recorded daily in terms of type, dosage, and monitoring strategy...
February 15, 2024: American Journal of Respiratory and Critical Care Medicine
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JOURNAL ARTICLE
Santosh B Murthy, Cenai Zhang, Shreyansh Shah, Lee H Schwamm, Gregg C Fonarow, Eric E Smith, Deepak L Bhatt, Wendy C Ziai, Hooman Kamel, Kevin N Sheth
BACKGROUND: Survivors of intracerebral hemorrhage (ICH) face an increased risk of ischemic cardiovascular events. Current ICH guidelines do not provide definitive recommendations regarding the use of antithrombotic and statin therapies. We, therefore, sought to study practice patterns and factors associated with the use of such medications after ICH. METHODS: This was a cross-sectional study of patients with ICH in the Get With The Guidelines-Stroke registry, between 2011 and 2021...
December 2023: Stroke; a Journal of Cerebral Circulation
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REVIEW
Rustam Al-Shahi Salman, Steven M Greenberg
This focused update about antiplatelet agents to reduce the high risk of major adverse cardiovascular events after stroke due to spontaneous (nontraumatic) intracerebral hemorrhage (ICH) complements earlier updates about blood pressure-lowering, lipid-lowering, and oral anticoagulation or left atrial appendage occlusion for atrial fibrillation after ICH. When used for secondary prevention in people without ICH, antiplatelet agents reduce the risk of major adverse cardiovascular event (rate ratio, 0.81 [95% CI, 0...
December 2023: Stroke; a Journal of Cerebral Circulation
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JOURNAL ARTICLE
Dongwon Yoon, Han Eol Jeong, Songhwa Choi, Daye Lee, Ju-Young Shin, Soo-Mee Bang
BACKGROUND: Nonpersistence in anticoagulation therapy is common and associated with undesirable clinical outcomes in patients with venous thromboembolism (VTE). METHODS: We investigated preceding clinical events of treatment nonpersistence (e.g., switching, discontinuing, or restarting) in VTE patients with and without active cancer using Korean claims database. RESULTS: Clinically significant events including thromboembolic events, hepatic function change and surgery preceded treatment nonpersistence, but heterogeneous distributions of clinical events were observed in the presence of active cancer...
October 26, 2023: Cancer Medicine
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JOURNAL ARTICLE
Eizen Yamamoto, Masashi Ogawa, Teppei Murata, Joji Ishikawa, Kazumasa Harada
We herein report a 99-year-old woman with hypertension and dyslipidemia. From the beginning of August 20XX, significant edema from the left thigh to the toes had been observed, so she had consulted her previous doctor. She had been suspected of having cellulitis and was given antibiotics, but no improvement in her symptoms was noted, so she was transferred to our hospital. The edema of the lower leg was localized to the left lower leg only, and the D-dimer level was as high as 16.6 μg/mL at her visit to the emergency room, so deep vein thrombosis (DVT) was suspected, and the patient received immediate hospitalization...
2023: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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JOURNAL ARTICLE
N Gennaro, E Ferroni, M Zorzi, G Denas, V Pengo
AIMS: We assessed the cumulative incidence of recurrent stroke, major bleeding and all-cause mortality associated with restarting antithrombotic treatment, in patients experiencing an anticoagulation-related event (stroke or major bleeding), occurred during anticoagulation therapy for AF. METHODS AND RESULTS: We performed a retrospective population-based analysis on linked claims data of patients resident in the Veneto Region, treated with DOACs for AF and discharged (2013-2020) from the hospital for stroke, intracranial haemorrhage (ICH), and major bleeding...
September 16, 2023: International Journal of Cardiology
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Misa Saeki, Ayako Watanabe, Kenji Momo, Yuka Kashiwabara, Tatsuki Iha, Takuya Nagata, Akiko Fujiwara, Katsumi Tanaka
KEY CLINICAL MESSAGE: A 97-year-old woman with gastrostomy had a drastic enhancement for PT-INR after starting antibiotic therapy. Possible causes include (1) vitamin K deficiency due to fasting and (2) a combination of warfarin and antibiotics. ABSTRACT: Geriatric and Asian-descent patients are more sensitive to the effects of warfarin, a key anticoagulant drug. In this report, we present a 97-year-old bedridden woman being treated with warfarin for cardiogenic cerebral infarction and femoral neck replacement as part of in-home medical care with a gastrostomy and was admitted to our hospital after developing pneumonia...
September 2023: Clinical Case Reports
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JOURNAL ARTICLE
Vignesh Vudatha, Yahya Alwatari, George Ibrahim, Tayler Jacobs, Kyle Alexander, Carlos Puig-Gilbert, Walker Julliard, Rachit Dilip Shah
BACKGROUND: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. METHODS: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified...
September 5, 2023: Journal of chest surgery
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JOURNAL ARTICLE
Kota Nakamura, Minako Nagai, Ippei Matsumoto, Sohei Satoi, Fuyuhiko Motoi, Manabu Kawai, Yasuo Hosouchi, Ryota Higuchi, Shugo Mizuno, Takao Ohtsuka, Keiichi Akahoshi, Kenichi Hakamada, Michiaki Unno, Hiroki Yamaue, Masafumi Nakamura, Itaru Endo, Masayuki Sho
BACKGROUND: We previously reported an association between antithrombotic therapy and an increased risk of postpancreatectomy hemorrhage (PPH). To validate our findings, we conducted a large-scale multicenter retrospective study from 63 high-volume centers in Japan. METHODS: Between 2015 and 2018, 7116 patients who underwent pancreatectomy were enrolled. The antithrombotic group consisted of 920 patients (12.9%) who received preoperative antithrombotic agents including aspirin, clopidogrel, ticlopidine, prasugrel, warfarin, and direct oral anticoagulants...
September 1, 2023: Journal of Hepato-biliary-pancreatic Sciences
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RANDOMIZED CONTROLLED TRIAL
Alexandros A Polymeris, Grzegorz M Karwacki, Bernhard M Siepen, Sabine Schaedelin, Dimitrios A Tsakiris, Christoph Stippich, Raphael Guzman, Christian H Nickel, Nikola Sprigg, Georg Kägi, Jochen Vehoff, Filip Barinka, Sebastian Thilemann, Marina Maurer, Benjamin Wagner, Christopher Traenka, Henrik Gensicke, Gian Marco De Marchis, Leo H Bonati, Urs Fischer, Werner J Z'Graggen, Krassen Nedeltchev, Susanne Wegener, Philipp Baumgartner, Stefan T Engelter, David J Seiffge, Nils Peters, Philippe A Lyrer
BACKGROUND: Evidence-based hemostatic treatment for intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOACs) is lacking. Tranexamic acid (TXA) is an antifibrinolytic drug potentially limiting hematoma expansion. We aimed to assess the efficacy and safety of TXA in NOAC-ICH. METHODS: We performed a double-blind, randomized, placebo-controlled trial at 6 Swiss stroke centers. Patients with NOAC-ICH within 12 hours of symptom onset and 48 hours of last NOAC intake were randomized (1:1) to receive either intravenous TXA (1 g over 10 minutes followed by 1 g over 8 hours) or matching placebo in addition to standard medical care via a centralized Web-based procedure with minimization on key prognostic factors...
September 2023: Stroke; a Journal of Cerebral Circulation
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MULTICENTER STUDY
Maurizio Paciaroni, Valeria Caso, Michele Romoli, Cecilia Becattini, Alexander Salerno, Costanza Rapillo, Fanny Simonnet, Davide Strambo, Isabella Canavero, Marialuisa Zedde, Rosario Pascarella, Sung-Il Sohn, Simona Sacco, Raffaele Ornello, Kristian Barlinn, Daniela Schoene, Jan Rahmig, Maria Giulia Mosconi, Ilaria Leone De Magistris, Andrea Alberti, Michele Venti, Giorgio Silvestrelli, Alfonso Ciccone, Marina Padroni, Michele Laudisi, Andrea Zini, Luana Gentile, Odysseas Kargiotis, Georgios Tsivgoulis, Rossana Tassi, Francesca Guideri, Maurizio Acampa, Luca Masotti, Elisa Grifoni, Alessandro Rocco, Marina Diomedi, Theodore Karapanayiotides, Stefan T Engelter, Alexandros A Polymeris, Annaelle Zietz, Fabio Bandini, Pietro Caliandro, Giuseppe Reale, Marco Moci, Aurelia Zauli, Manuel Cappellari, Andrea Emiliani, Antonio Gasparro, Valeria Terruso, Marina Mannino, Elisa Giorli, Danilo Toni, Marco Andrighetti, Anne Falcou, Lina Palaiodimou, George Ntaios, Dimitrios Sagris, Efstathia Karagkiozi, Anastasia Adamou, Panagiotis Halvatsiotis, Yuriy Flomin, Umberto Scoditti, Antonio Genovese, Nemanja Popovic, Leonardo Pantoni, Francesco Mele, Nicola Molitierno, Piergiorgio Lochner, Alessandro Pezzini, Massimo Del Sette, Davide Sassos, Sotirios Giannopoulos, Maria Kosmidou, Evangelos Ntais, Enrico Maria Lotti, Vincenzo Mastrangelo, Alberto Chiti, Andrea Naldi, Peter Vanacker, Mario Ferrante, Vera Volodina, Michelangelo Mancuso, Nicola Giannini, Marco Baldini, Kostantinos Vadikolias, Sofia Kitmeridou, Carlo Emanuele Saggese, Tiziana Tassinari, Valentina Saia, Patrik Michel
INTRODUCTION: The best therapeutic strategy for patients with mechanical heart valves (MHVs) having acute ischemic stroke during treatment with vitamin K antagonists (VKAs) remain unclear. Being so, we compared the outcomes for: (i) full dose heparin along with VKA (bridging therapy group) and (ii) restarting VKA without heparin (nonbridging group). PATIENTS AND METHODS: For this multicenter observational cohort study, data on consecutive acute ischemic stroke patients with MHV was retrospectively collected from prospective registries...
December 2023: European Stroke Journal
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REVIEW
Fabiana Lucà, Furio Colivicchi, Fabrizio Oliva, Maurizio Abrignani, Giorgio Caretta, Stefania Angela Di Fusco, Simona Giubilato, Stefano Cornara, Concetta Di Nora, Andrea Pozzi, Irene Di Matteo, Anna Pilleri, Carmelo Massimiliano Rao, Antonio Parlavecchio, Roberto Ceravolo, Francesco Antonio Benedetto, Roberta Rossini, Raimondo Calvanese, Sandro Gelsomino, Carmine Riccio, Michele Massimo Gulizia
Intracranial hemorrhage (ICH) is considered a potentially severe complication of oral anticoagulants (OACs) and antiplatelet therapy (APT). Patients with atrial fibrillation (AF) who survived ICH present both an increased ischemic and bleeding risk. Due to its lethality, initiating or reinitiating OACs in ICH survivors with AF is challenging. Since ICH recurrence may be life-threatening, patients who experience an ICH are often not treated with OACs, and thus remain at a higher risk of thromboembolic events...
2023: Frontiers in Cardiovascular Medicine
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