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Anticoagulation management prior to procedures

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https://www.readbyqxmd.com/read/28283268/perioperative-management-of-vitamin-k-antagonists-in-patients-with-low-thromboembolic-risk-undergoing-elective-surgery-a-prospective-experience
#1
Ana Florencia Becerra, María Teresita Cornavaca, José Ignacio Revigliono, Alejandro Contreras, Ricardo Albertini, Aldo Hugo Tabares
BACKGROUND AND OBJECTIVES: To quantify thromboembolic and bleeding events in patients with low thromboembolic risk, who were chronically receiving vitamin K antagonists and undergoing elective surgery. MATERIAL AND METHODS: A descriptive, prospective, single-center study was conducted between December 2010 and July 2014. Patients aged over 18 years old, chronically anticoagulated with vitamin K antagonists and admitted for elective surgery were included in the study...
March 7, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28223868/assessment-of-novel-oral-anticoagulant-use-within-a-community-teaching-hospital
#2
Sultan Alghadeer, Lori Hornsby
Background: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. SETTING: A community teaching hospital in the United States...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28210454/managing-patients-taking-edoxaban-in-dentistry
#3
REVIEW
Adrian Curto, Daniel Curto, Jorge Sanchez
BACKGROUND: Anticoagulation therapy is used in several conditions to prevent or treat thromboembolism. A new group of oral anticoagulants with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. The Food and Drug Administration has approved edoxaban, dabigatran, rivaroxaban and apixaban. Their advantages include: predictable pharmacokinetics, drug interactions and limited food, rapid onset of action and short half-life...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#4
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28074293/-management-of-noak-administration-during-invasive-or-surgical-interventions-when-and-how-to-pause-and-when-to-restart
#5
M Buerke, H M Hoffmeister
Many patients under oral anticoagulation therapy need percutaneous or surgical interventions/operations. For vitamin K antagonists (VKA), there are recommendations regarding preoperative or postoperative administration. Management of the new oral anticoagulants (NOAC) was supposed to be easier - but some aspects must be considered. Due to the different pharmacokinetic profiles of substances such as dabigatran, rivaroxaban, apixaban, and edoxaban, different recommendations are given.Upon periprocedural management, thromboembolic risk has to be considered in patients treated with NOACs...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28017846/increased-post-procedural-non-gastrointestinal-adverse-events-after-outpatient-colonoscopy-in-high-risk-patients
#6
David A Johnson, David Lieberman, John M Inadomi, Uri Ladabaum, Richard C Becker, Seth A Gross, Kristin L Hood, Susan Kushins, Mark Pochapin, Douglas J Robertson
BACKGROUND & AIMS: The incidence and predictors of non-gastrointestinal (GI) adverse events (AEs) after colonoscopy are not well-understood. We studied the effects of antithrombotic agents, cardiopulmonary comorbidities, and age on risk of non-GI AEs after colonoscopy. METHODS: We performed a retrospective longitudinal analysis to assess the diagnosis, procedure, and prescription drug codes in a United States commercial claims database (March 2010-March 2012). Data from patients at increased risk (n = 82,025; defined as patients with pulmonary comorbidities or cardiovascular disease requiring antithrombotic medications) were compared with data from 398,663 average-risk patients...
December 23, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28008269/perioperative-management-of-direct-oral-anticoagulants-doacs-a-systemic-review
#7
REVIEW
Tagore Sunkara, Emmanuel Ofori, Vadim Zarubin, Megan E Caughey, Vinaya Gaduputi, Madhavi Reddy
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#8
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27913535/reversing-vitamin-k-antagonists-making-the-old-new-again
#9
Sabine Eichinger
Vitamin K antagonists (VKAs) are commonly used for the prevention and treatment of thrombotic disorders. The response to VKAs is highly variable due to their specific interaction with the vitamin K cycle, and hence interference with hepatic synthesis of vitamin K-dependent coagulation factors. Monitoring the anticoagulant effect of VKAs by assessing the patient's international normalized ratio (INR) is essential because complications are closely related to the intensity of anticoagulation. Treatment with VKAs contains a substantial risk of bleeding with a high case fatality rate...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27818480/rivaroxaban-for-periprocedural-anticoagulation-therapy-in-japanese-patients-undergoing-catheter-ablation-of-paroxysmal-non-valvular-atrial-fibrillation
#10
MULTICENTER STUDY
Mihoko Kawabata, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Yasuteru Yamauchi, Junichi Nitta, Masahiko Goya, Kenzo Hirao
Direct oral anticoagulants (DOACs) have been shown to be safe and effective for the prevention of stroke in nonvalvular atrial fibrillation (NVAF) patients, however, experience with peri-AF ablation management of DOACs is scarce. This study aimed to investigate the safety and feasibility of periprocedural anticoagulation therapy with rivaroxaban in Japanese patients undergoing paroxysmal non-valvular AF (NVAF) ablation using radiofrequency energy.This study was a multicenter, prospective pilot study. In paroxysmal NVAF patients, rivaroxaban (15 mg or 10 mg once-daily) was started at least 4 weeks prior to AF ablation, discontinued on the day of the procedure, resumed within 24 hours after ablation, and continued at least 3 months afterwards...
December 2, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27761188/percutaneous-retrieval-of-an-embolized-kyphoplasty-cement-fragment-from-the-pulmonary-artery-a-case-report-and-literature-review
#11
Nicole A Lamparello, Vijay Jaswani, Keith DeSousa, Maksim Shapiro, Sandor Kovacs
We present a case of a 41-year-old man with symptomatic pulmonary cement embolism following percutaneous vertebral augmentation, which was successfully retrieved via a percutaneous endovascular approach, a novel technique with only two prior cases reported. Cement leakage, including venous embolization of cement into the cardiopulmonary circulation, is a known potential complication following percutaneous kyphoplasty and vertebroplasty. While many patients with pulmonary cement embolism are asymptomatic and likely go undiagnosed, others experience respiratory distress and hemodynamic compromise requiring surgical and medical intervention...
July 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27720627/-challenges-in-renal-transplantation
#12
R Thuret, F Kleinclauss, N Terrier, G Karam, M O Timsit
OBJECTIVES: To describe kidney transplantation surgical techniques and to propose strategies in high-risk recipients. MATERIAL AND METHODS: Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov/) and Embase (http://www.embase.com/) database using the following keywords, alone or in association, "renal transplantation; peripheral arterial disease; obesity; third and fourth transplantation; robotic-assisted kidney transplant; anticoagulant therapy; dual kidney transplant"...
November 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27668068/blood-thinners-and-gastrointestinal-endoscopy
#13
REVIEW
Monjur Ahmed
As the number of diagnostic and therapeutic gastrointestinal endoscopies is increasing, and there is an increase in number of patients taking blood thinners, we are seeing more and more patients on blood thinners prior to endoscopic procedures. Gastrointestinal bleeding or thromboembolism can occur in this category of patients in the periendoscopic period. To better manage these patients, endoscopists should have a clear concept about the various blood thinners in the market. Patients' risk of thromboembolism off anticoagulation, and the risk of bleeding from endoscopic procedures should be assessed prior to endoscopy...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27661060/cytochrome-p450-2c9-gene-polymorphism-and-warfarin-maintenance-dosage-in-pediatric-patients-a-systematic-review-and-meta-analysis
#14
REVIEW
Jinhua Zhang, Lihong Tian, Jinlong Huang, Sihan Huang, Tingting Chai, Jianzhen Shen
AIM: To assess the effect of Cytochrome P450 2C9 (CYP2C9) gene polymorphism on pediatric warfarin maintenance dosage requirement. METHODS: A previously developed search strategy was conducted in PubMed, EMBASE, and the Cochrane Library. Eligible studies published prior to January 27, 2016, were identified and compared against strict inclusion/exclusion criteria. Required data were extracted, and researchers were consulted for additional data if needed. Review Manager version 5...
February 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27615054/hypertensive-emergency-presenting-with-an-isolated-celiac-artery-dissection-a-rare-case-study
#15
Natalie Swergold, Steven Kozusko, Carlos Rivera, Cindy Sturt
INTRODUCTION: To our knowledge the most recent article on celiac dissection was published in 2015 and reported 24 known cases of spontaneous isolated celiac trunk dissection [2]. While some of those cases reported hypertension as a risk factor, no other case presents as hypertensive emergency with an isolated celiac artery dissection. PRESENTATION OF CASE: A 43 year-old man with a past medical history of uncontrolled hypertension, for which he had reportedly been non-compliant with follow-up, presented with complaints of severe, sudden-onset epigastric pain which was non-radiating and constant for 1 hour prior to arrival...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27610349/single-institution-experience-with-the-ladd-s-procedure-in-patients-with-heterotaxy-and-stage-i-palliated-single-ventricle
#16
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27581709/management-of-dabigatran-associated-bleeding-with-two-doses-of-idarucizumab-plus-hemodialysis
#17
Kaylee K Marino, Raul A Santiago, Richard B Dew, Nancy Berliner, Jean M Connors, Nathan T Connell, John Kevin Tucker
Vitamin K antagonists have been a mainstay of treatment for patients requiring anticoagulation for atrial fibrillation, but direct oral anticoagulants, such as dabigatran, have become increasingly prescribed. Compared with warfarin, dabigatran has a significantly lower risk of life-threatening bleeding; however, bleeding events can still occur, supporting the need for effective reversal strategies. Idarucizumab was recently approved by the U.S. Food and Drug Administration to reverse the anticoagulant effects of dabigatran when life-threatening bleeding occurs or an urgent need for an invasive medical procedure exists...
October 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27579410/getting-out-of-a-pccl-percutaneous-cholecystolithotomy-as-a-salvage-treatment-option-for-gallstone-removal-in-patients-deemed-unfit-for-standard-surgical-approaches
#18
Adam C Calaway, Michael S Borofsky, Casey A Dauw, James E Lingeman
Definitive management of acute cholecystitis or symptomatic cholelithiasis in exceedingly high-risk patients remains a clinical dilemma. In certain cases, treatment through a percutaneous approach following standard techniques and principles similar to those of percutaneous nephrolithotomy may be considered. However, one potential challenge, particularly among a high-risk population, is the possible necessity to stay on obligate anticoagulation for pre-existing medical reasons. To date, there have been no prior reports documenting the role of this procedure in patients on systemic anticoagulation, particularly clopidogrel...
2016: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/27576696/-consensus-statement-management-of-oral-anticoagulation-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation
#19
Thomas Maria Helms, Sigmund Silber, Andreas Schäfer, Florian Masuhr, Frederick Palm, Harald Darius, Karsten Schrör, Dietmar Bänsch, Peter Bramlage, Johannes Hankowitz, Christoph A Karle, Tom Stargardt, Joachim Weil, Johann Christoph Geller
With the introduction of edoxaban last year in Germany, four nonvitamin K antagonist oral anticoagulants are now available for stroke prevention in patients with nonvalvular atrial fibrillation. These novel oral anticoagulants (NOAC) represent an attractive new option compared to vitamin K antagonists (e.g., warfarin or phenprocoumon) due to simple use and fewer interactions with other drugs or food. Therefore, no INR monitoring and dosage adjustments are required for NOAC. The compelling clinical advantage of NOAC is the dramatic risk reduction of hemorhagic stroke and intracranial bleeding compared to current standard...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27402803/direct-oral-anticoagulants-unique-properties-and-practical-approaches-to-management
#20
REVIEW
Geoffrey D Barnes, Brian Kurtz
Since 2009, four direct oral anticoagulants (DOACs) have been introduced for treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. While they are currently first-line therapy for a majority of patients, there are a number of clinical situations where warfarin is preferable. In both randomised trials and real-world populations, use of DOACs significantly reduces the risk of intracranial haemorrhage as compared with warfarin. While drug-specific reversal agents are currently only available for dabigatran, andexanet alpha is pending approval for reversal of factor Xa inhibitors, reducing concerns about major bleeding for many patients and providers...
October 15, 2016: Heart: Official Journal of the British Cardiac Society
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