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Perioperative bridging

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https://www.readbyqxmd.com/read/29770858/-management-of-anticoagulants-in-ophthalmic-surgery-a-survey-among-ophthalmic-surgeons-in-germany
#1
N Feltgen, B Mele, T Dietlein, C Erb, A Eckstein, A Hager, A Heiligenhaus, H Helbig, H Hoerauf, E Hoffmann, D Pauleikhoff, M Schittkowski, B Seitz, C Sucker, S Suffo, U Schaudig, F Tost, S Thurau, P Walter, J Koscielny
INTRODUCTION: As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS: A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo...
May 16, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29710221/what-surgeons-should-know-about-non-vitamin-k-oral-anticoagulants-a-review
#2
Atul Verma, Andrew C T Ha, James T Rutka, Subodh Verma
Importance: Non-vitamin K oral anticoagulants (NOACs) are increasingly prescribed for patients to treat or prevent arterial or venous thromboembolism. The following 4 NOAC agents are approved by the US Food and Drug Administration for clinical use: dabigatran etexilate, apixaban, edoxaban tosylate, and rivaroxaban. A good understanding of these agents' pharmacologic properties is important for surgeons given their marked differences compared with warfarin sodium. This review highlights key practical issues surrounding the use of NOACs in the perioperative setting...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29701347/giant-ruptured-common-iliac-artery-infected-aneurysm
#3
Pedro Pinto Sousa, Sérgio Teixeira, João Gonçalves, Carlos Veiga, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Saccular mycotic aorto-iliac aneurysms are extremely rare and when presented with ruptured, they are an important life- threatening condition. METHODS: We present a 52 years old male transferred from another Hospital and admitted to the emergency room with a ruptured iliac artery aneurysm. RESULTS: He complained of persistent fever and abdominal discomfort that swiftly established as hemorrhagic shock. Imagiological study with angioCT revealed a ruptured left common iliac artery saccular aneurysm with 90mm...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29688934/perioperative-management-of-the-gynecologic-patient-on-long-term-anticoagulation
#4
Ammon M Fager, Elizabeth Deans, Andra H James
The perioperative management of patients taking antithrombotic or antiplatelet medications is based on an assessment of the individual patient's risk for thrombosis or bleeding, the specific medication involved, and the nature of the planned procedure. This article describes specific strategies for whether and how these medications should be interrupted before gynecologic procedures, when they can be restarted following the procedure, and whether bridging therapy should be considered.
June 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29659027/perioperative-hematoma-with-subcutaneous-icd-implantation-impact-of-anticoagulation-and-antiplatelet-therapies
#5
Seth H Sheldon, Ryan Cunnane, Madhav Lavu, Valay Parikh, Donita Atkins, Yeruva Madhu Reddy, Loren D Berenbom, Martin P Emert, Rhea Pimentel, Raghuveer Dendi, Dhanunjaya R Lakkireddy
BACKGROUND: The safety of perioperative anticoagulation (AC) and antiplatelet (AP) therapy with subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is unknown. The purpose of this study was to identify the risk factors associated with hematoma complicating S-ICD implantation. METHODS: Records were retrospectively reviewed from 200 consecutive patients undergoing S-ICD implantation at two academic medical centers. A hematoma was defined as a device site blood accumulation requiring surgical evacuation, extended hospital stay, or transfusion...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29616499/incidence-of-complications-following-thermocautery-assisted-circumcisions
#6
Ahmet Ali Tuncer, Mutlu Deger
PURPOSE: This study aimed to examine the short- and long-term complications of thermocautery-assisted circumcisions. MATERIALS AND METHODS: A total of 1780 children who consecutively underwent thermocautery-assisted circumcisions from  May 2014 to May 2016 in Yuksekova State Hospital in Turkey were included in this study. Thesechildren were classified into perioperative, early postoperative, and long-term complication groups. In addition, the age groups were compared in terms of complications...
April 4, 2018: Urology Journal
https://www.readbyqxmd.com/read/29611483/management-of-antithrombotic-therapy-in-patients-with-coronary-artery-disease-or-atrial-fibrillation-who-underwent-abdominal-surgical-operations
#7
Dimitrios Schizas, Maria Kariori, Konstantinos Dean Boudoulas, Gerasimos Siasos, Nikolaos Patelis, Charalampos Kalantzis, Moldovan Carmen-Maria, Manolis Vavuranakis
BACKGROUND: Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. METHODS: The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations...
April 2, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29564862/-anesthetic-care-of-patient-with-heroin-addiction-a-case-report
#8
Wen-Yi Lee, Shu-Yu Kuo
The use of illegal drugs in Taiwan is on the rise. Drug addicts often have complex physical, psychological, and social problems. In addition, they often avoid disclosing their illicit drug use by deceit, concealment, or under-reporting. Building and maintaining relationships of trust with drug-addict patients has become a critical issue in achieving better care quality. In this case report, we report on an anesthesia care process for a heroin addict who was admitted for open reduction and internal fixation surgery for the femur and patella fractures after a car accident...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#9
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452792/clinical-and-radiological-features-of-spinal-extradural-arachnoid-cysts-valve-like-mechanism-involving-the-nerve-root-fiber-as-a-possible-cause-of-cyst-expansion
#10
Kazuaki Morizane, Shunsuke Fujibayashi, Bungo Otsuki, Takeshi Sakamoto, Ryosuke Tsutsumi, Seiichi Odate, Akira Kusuba, Shuichi Matsuda
BACKGROUND: Although a valve-like mechanism has been proposed for expansion of spinal extradural arachnoid cysts (SEACs), the detailed mechanism remains unclear. Moreover, closure of the communication site is essential during surgery, but the method to identify the communication site remains unclear. The aim of this study was to determine the detailed mechanism of expanding SEACs through retrospective analysis of SEAC cases undergoing surgery and to elucidate the characteristics of the communication sites...
February 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29428146/management-of-perioperative-anticoagulation-for-device-implantation
#11
REVIEW
Merrill H Stewart, Daniel P Morin
Periprocedural management of anticoagulation for cardiac device implantation has evolved over the past 20 years. The traditional paradigm of vitamin K antagonist interruption with heparin bridging has now been shown to be less safe than continuation of vitamin K antagonists at therapeutic levels. Dual antiplatelet therapy during device implantation poses substantial risk but is often necessary. The safest dosing strategy for newer direct oral anticoagulants is still not clear.
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29394803/-obstructive-colon-cancer-with-triple-vessel-coronary-artery-disease-a-case-report
#12
Koji Ueda, Seiichi Shinji, Yosuke Ishii, Hiroshi Yamawaki, Takeshi Yamada, Michihiro Koizumi, Yasuyuki Yokoyama, Masahiro Hotta, Goro Takahashi, Takuma Iwai, Kohki Takeda, Keisuke Hara, Keiichirou Oota, Takashi Nitta, Eiji Uchida
The patient was a 70-year-old woman who was diagnosed with obstructive transverse colon cancer suspected of invading the abdominal wall by abdominal CT imaging. Since the preoperative electrocardiogram showed an ischemic change, echocardiography and coronary angiography were performed. We diagnosed chronic heart failure and angina pectoris because echocardiography showed low cardiac function(left ventricular ejection fraction; LVEF 37%)and coronary angiography indicated triple-vessel disease. We firstly performed coronary artery bypass graft surgery following self-expanding metallic stent placement as a bridge to surgery(BTS), because we judged this patient as a perioperative high-risk case...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29357325/buprenorphine-formulations-clinical-best-practice-strategies-recommendations-for-perioperative-management-of-patients-undergoing-surgical-or-interventional-pain-procedures
#13
Adrian B Jonan, Alan D Kaye, Richard D Urman
BACKGROUND: Starting with approval for clinical use in the treatment of opioid dependence in October 2002 by the Food and Drug Administration (FDA), buprenorphine has become an integral treatment option and in recent years, in chronic pain management. Buprenorphine possesses a unique pharmacodynamic and pharmacokinetic profile that can potentially make perioperative analgesia challenging. OBJECTIVES: To date no unified guidelines or recommendations are available for buprenorphine product management during the perioperative period...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29349616/outcomes-of-utilizing-absorbable-mesh-as-an-adjunct-to-posterior-sheath-closure-during-complex-posterior-component-separation
#14
J S Winder, A Majumder, M Fayezizadeh, Y W Novitsky, E M Pauli
BACKGROUND: A minority of patients undergoing posterior component separation (PCS) have abdominal wall defects that preclude complete reconstruction of the visceral sac with native tissue. The use of absorbable mesh bridges (AMB) to span such defects has not been established. We hypothesized that AMB use during posterior sheath closure of PCS is safe and provides favorable outcomes. METHODS: We performed a retrospective review of consecutive patients undergoing PCS with AMB at two hernia centers...
April 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29337783/s1-sacrectomy-for-re-recurrent-rectal-cancer-our-experience-with-reconstruction-using-an-expandable-vertebral-body-replacement-device
#15
Daniel Jin Keat Lee, Kelvin Yafan Wang, Peter Michael Sagar, Jake Timothy
INTRODUCTION: R0 resection is achieved by high sacrectomy for local recurrence of colorectal cancer, but significant rates of perioperative complications and long-term patient morbidity are associated with this procedure. In this report, we outline our unique experience of using an expandable cage for vertebral body reconstruction following S1 sacrectomy in a 66-year-old patient with re-recurrent rectal cancer. We aim to highlight several key steps, with a view to improving postoperative outcomes...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#16
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
February 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#17
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29312713/outcomes-of-perioperative-extracorporeal-membrane-oxygenation-use-in-patients-undergoing-lung-transplantation
#18
Joo Han Song, Ji Eun Park, Jin Gu Lee, Chang Young Lee, Kyung Sik Nam, Jee Won Suh, Anes Kim, Seung Hyun Lee, Hyun Chel Joo, Young Nam Youn, Song Yee Kim, Moo Suk Park, Hyo Chae Paik
Background: The aim of this single-center study is to review the transplant outcomes of patients receiving lung transplantation (LTx) using intraoperative extracorporeal membrane oxygenation (ECMO) according to the perioperative use of ECMO. Methods: We retrospectively reviewed the transplant outcomes of 107 consecutive patients who underwent LTx using intraoperative ECMO between March 2013 and August 2016 at Severance Hospital of Yonsei University (Seoul, Korea)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29305226/extracorporeal-membrane-oxygenation-in-congenital-heart-disease
#19
REVIEW
Kiona Y Allen, Catherine K Allan, Lillian Su, Mary E McBride
This review article will discuss the indications for and outcomes of neonates with congenital heart disease who receive extracorporeal membrane oxygenation (ECMO) support. Most commonly, ECMO is used as a perioperative bridge to recovery or temporary support for those after cardiac arrest or near arrest in patients with congenital or acquired heart disease. What had historically been considered a contraindication to ECMO, is evolving and more of the sickest and most complicated babies are cared for on ECMO...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29283294/evaluating-the-role-of-clinical-pharmacists-in-pre-procedural-anticoagulation-management
#20
Akash Kataruka, Elizabeth Renner, Geoffrey D Barnes
OBJECTIVES: While physicians are typically responsible for managing perioperative warfarin, clinic pharmacists may improve pre-procedural decision-making. We assessed the impact of pharmacist-driven care for chronic warfarin-treated patients undergoing outpatient right heart catheterization (RHC). METHODS: 200 warfarin patients who underwent RHC between January 2012 and September 2015 were analyzed. Pharmacist-care (n = 79) was compared to the usual care model (n = 121)...
February 2018: Hospital Practice (Minneapolis)
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