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Perioperative anticoagulation

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https://www.readbyqxmd.com/read/27913536/reversal-of-direct-oral-anticoagulants-a-practical-approach
#1
Andrew W Shih, Mark A Crowther
Direct oral anticoagulants (DOACs) have at least noninferior efficacy compared with other oral anticoagulants and have ancillary benefits, including overall better safety profiles, lack of the need for routine monitoring, rapid onset of action, and ease of administration. Reversal of these agents may be indicated in certain situations such as severe bleeding and for perioperative management. DOAC-associated bleeding should be risk stratified: patients with moderate or severe bleeding should have the DOAC discontinued and reversal strategies should be considered...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27889960/current-management-in-transurethral-therapy-of-benign-prostatic-obstruction-in-patients-on-oral-anticoagulation-a-worldwide-questionnaire
#2
Benedikt Becker, Ann Sophie Knipper, Andreas J Gross, Christopher Netsch
OBJECTIVE: To assess the current treatment of benign prostatic obstruction (BPO) in patients on ongoing oral anticoagulation (OA). METHODS: An internet survey was sent to all active members of the Endourological Society. The survey contained 32 questions regarding transurethral treatment of BPO in patients on ongoing OA, different techniques and arising complications. RESULTS: Out of all members (n=2000) of the Endourological Society, 133 participated in our survey...
November 27, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27876255/patient-and-perioperative-variables-affecting-30-day-readmission-for-surgical-complications-after-hip-and-knee-arthroplasties-a-matched-cohort-study
#3
Benjamin F Ricciardi, Kathryn K Oi, Steven B Daines, Yuo-Yu Lee, Amethia D Joseph, Geoffrey H Westrich
BACKGROUND: Changes in reimbursement for total hip and knee arthroplasties (THA and TKA) have placed increased financial burden of early readmission on hospitals and surgeons. Our purpose was to characterize factors of 30-day readmission for surgical complications after THA and TKA at a single, high-volume orthopedic specialty hospital. METHODS: Patients with a diagnosis of osteoarthritis and who were readmitted within 30 days of their unilateral primary THA or TKA procedure between 2010 and 2014...
October 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27861383/living-donor-renal-transplantation-in-patients-with-antiphospholipid-syndrome-a-case-report
#4
Ji Yoon Choi, Joo Hee Jung, Sung Shin, Young Hoon Kim, Duck Jong Han
INTRODUCTION: Antiphospholipid syndrome (APS), autoantibodies directed against phospholipid-binding proteins are associated with cause vascular thrombosis. Patients with APS requiring renal transplantation are at risk of early graft loss due to arterial or venous thrombosis, or thrombotic microangiopathy (TMA). Here, we report 3 cases of successful renal transplantation in patients with APS. CLINICAL FINDINGS: A 53-year-old man with end-stage renal disease (ESRD) had experienced bilateral deep venous thrombosis (DVT) in the lower extremities 16 years ago and was administered warfarin...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27849664/perioperative-pharmacological-thromboprophylaxis-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#5
Qiang Guo, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Xiaojiong Du
OBJECTIVE: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation. BACKGROUND: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management. METHODS: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849513/venous-thoracic-outlet-syndrome-the-role-of-early-rib-resection
#6
Vienna G Katana, Jeffrey S Weiss
The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849307/cardiopulmonary-bypass-ischemic-hepatitis-reported-in-five-patients
#7
Telma A Damasceno, Adilson Scorzoni, Fernando Chahud, Alfredo José Rodrigues, Walter Vilella de Andrade Vicente, Paulo Roberto Barbosa Evora
Objective: In cardiac surgery, the lung, renal and neurological events are the most frequent complications. Less common, acute liver failure is a serious complication that adds high morbidity, mortality, and costs. Therefore, this communication aimed to retrospectively evaluate five patients who presented, in 2014, severe acute liver failure in the immediate postoperative period. Methods: Retrospective data analysis of patients' medical records that showed severe liver failure has been computed in the medical records of five patients undergoing cardiac surgery at the Hospital da Faculdade de Medicina de Ribeirão Preto - USP in the immediate postoperative period from February 1, 2014 to December 12, 2014...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27846465/perioperative-atrial-fibrillation-is-associated-with-increased-one-year-mortality-in-elderly-patients-after-repair-of-hip-fracture
#8
David Leibowitz, Chen Abitbol, Ronny Alcalai, Gurion Rivkin, Leonid Kandel
BACKGROUND: Hip fracture repair is commonly performed in elderly adults and is associated with high mortality. Limited data address the significance of perioperative atrial fibrillation (AF) and its subsequent treatment in emergent orthopedic surgery in the elderly. This study aimed to determine whether newly diagnosed AF among patients initially in sinus rhythm undergoing hip fracture repair is predictive of one-year mortality and whether medical therapy of AF attenuated this finding...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27824418/-specifics-for-anticoagulation-with-atrial-fibrillation-triple-therapy-and-perioperative-bridging
#9
Stefan Frantz
Patients with atrial fibrillation have in large parts an indication for full anticoagulation. Practical problems develop when there is an additional indication for a platelet inhibitory treatment, so called triple therapy, in case of percutaneous coronary intervention or how to manage anticoagulation in case of an operation. Clinical studies are relatively limited. Essentially, an individualized approach is necessary taking into account the bleeding on the one and the thromboembolic risk on the other side. In this review we a give a pragmatic treatment approach with discussion of the recent literature...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27807780/retroperitoneal-haematoma-in-a-postoperative-alif-patient-taking-rivaroxaban-for-atrial-fibrillation
#10
Praveena Deekonda, Oliver M Stokes, Daniel Chan
BACKGROUND: Novel oral anticoagulants (NOACs) are being increasingly used in the secondary prevention of thromboembolic stroke in patients with atrial fibrillation. Patients taking NOACs are difficult to manage perioperatively, and several unexpected complications have been reported in these patients. CASE REPORT: We report a case of a rivaroxaban-induced retroperitoneal haematoma in a 72-year-old man who underwent an L5/S1 anterior lumbar interbody fusion (ALIF) for grade 1 spondylolytic spondylolisthesis...
November 2, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27803121/new-onset-atrial-fibrillation-after-anatomic-lung-resection-predictive-factors-treatment-and-follow-up-in-a-uk-thoracic-centre
#11
Megan Garner, Tom Routledge, Juliet E King, John E Pilling, Lukacs Veres, Karen Harrison-Phipps, Andrea Bille, Leanne Harling
OBJECTIVES: Postoperative atrial fibrillation (POAF) increases morbidity, hospital stay and healthcare expenditure. This study aims to determine the perioperative factors correlating with POAF as well as to evaluate both treatment strategies and AF persistence beyond discharge. METHODS: The records of all patients undergoing anatomical lung resection over a 1-year period were retrospectively reviewed. Patients with a history of arrhythmia were excluded. POAF was defined by clinical diagnosis and electrocardiography...
November 1, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27799233/short-term-risk-of-bleeding-during-heparin-bridging-at-initiation-of-vitamin-k-antagonist-therapy-in-more-than-90%C3%A2-000-patients-with%C3%A2-nonvalvular-atrial-fibrillation-managed-in-outpatient-care
#12
Kim Bouillon, Marion Bertrand, Lotfi Boudali, Pierre Ducimetière, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Several studies have recently examined the risks of bleeding and of ischemic stroke and systemic embolism associated with perioperative heparin bridging anticoagulation in patients with nonvalvular atrial fibrillation. However, few studies have investigated bridging risks during vitamin K antagonist initiation in outpatient settings. METHODS AND RESULTS: A retrospective cohort study was conducted on individuals starting oral anticoagulation between January 2010 and November 2014 for nonvalvular atrial fibrillation managed in outpatient care and identified from French healthcare insurance...
October 31, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27789729/single-versus-double-antiplatelet-therapy-in-patients-undergoing-coronary-artery-bypass-grafting-with-coronary-endarterectomy-mid-term-results-and-clinical-implications
#13
Marco Russo, Paolo Nardi, Guglielmo Saitto, Emanuele Bovio, Antonio Pellegrino, Antonio Scafuri, Giovanni Ruvolo
OBJECTIVES: Coronary endarterectomy (CE) represents a useful adjunctive technique to coronary artery bypass grafting (CABG) in the presence of diffuse coronary artery disease. Nevertheless, the long-term patency of the graft remains unclear, and no standard anticoagulation and antiplatelet protocols exist for use after CE. The aim of this retrospective study was to evaluate and possibly to clarify the role of single (SAT) versus dual antiplatelet therapy (DAT) at mid-term follow-up. METHODS: Between January 2006 and December 2013, CE was performed in 90 patients (mean age 67 ± 8...
October 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27776904/prevalence-of-venous-thromboembolic-events-is-low-in-asians-after-total-knee-arthroplasty-without-chemoprophylaxis
#14
Hamid Rahmatullah Bin Abd Razak, Noorul Faeyza Binte Abd Razak, Hwee-Chye Andrew Tan
BACKGROUND: This retrospective cohort study was designed to establish the prevalence of clinically significant venous thromboembolic events (VTE) in our patients undergoing total knee arthroplasty (TKA) without chemoprophylaxis. METHODS: A single-surgeon cohort of patients who underwent TKA from 2006 to 2014 were included. All patients had a pneumatic tourniquet applied and a drain inserted postoperatively. Tranexamic acid was not used perioperatively. All patients were under a standardized postoperative protocol with routine mechanical prophylaxis against VTE...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27770654/optimal-perioperative-management-of-antithrombotic-agents-in-patients-with-chronic-subdural-hematoma
#15
Toshiyuki Amano, Kenta Takahara, Naoki Maehara, Takafumi Shimogawa, Nobutaka Mukae, Tetsuro Sayama, Shoji Arihiro, Shuji Arakawa, Takato Morioka, Sei Haga
OBJECTIVE: The use of antithrombotic agents such as anticoagulants and antiplatelet agents is widespread, and the opportunities to treat patients with chronic subdural hematoma (CSDH) under antithrombotic therapy are growing. However, whether antithrombotic therapy contributes to postoperative complications and recurrences of CSDH and how these agents should be managed in the surgical treatment of CSDH remains unclear. METHODS: We retrospectively analyzed 150 consecutive patients with CSDH who underwent neurosurgical interventions at Kyushu Rosai Hospital from 2011 to 2015 and followed them for more than 3 months...
October 7, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27759465/thromboembolic-and-major-bleeding-events-in-relation-to-perioperative-bridging-of-vitamin-k-antagonists-in-649-fast-track-total-hip-and-knee-arthroplasties
#16
Christoffer C Jørgensen, Henrik Kehlet
Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies. Patients and methods - This was an observational cohort treatment study in consecutive primary unilateral total hip and knee arthroplasty patients between January 2010 and November 2013 in 8 Danish fast-track departments. Data were collected prospectively on preoperative comorbidity and anticoagulants in patients with preoperative vitamin K antagonist (VKA) treatment...
October 19, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27756675/utilization-of-a-technique-of-percutaneous-s2-alar-iliac-fixation-in-immunocompromised-patients-with-spondylodiscitis-two-case-reports
#17
Haruki Funao, Khaled M Kebaish, Norihiro Isogai, Takahiro Koyanagi, Morio Matsumoto, Ken Ishii
BACKGROUND: Spondylodiscitis still remains a serious problem especially in immunocompromised patients. Surgery is necessary when non-surgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe two cases in which spondylodiscitis in the lumbosacral spine was treated with a percutaneous stabilization using S2 alar-iliac (S2AI) screw technique...
October 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27755410/the-rate-of-epistaxis-incidence-in-new-generation-anticoagulants-and-perioperative-approach-in-otorhinolaryngological-practices
#18
Ozan Gökdoğan, Ilker Akyildiz, Begum Yetis Sayin, Sercan Okutucu, Ali Cevat Tanalp, Necmi Arslan
Nose bleeding is a common situation seen in otorhinolaryngological practices. One of the greatest risk factors in nose bleeding is the use of anticoagulant medicine. With the medicine developed in recent years, the risk of nose bleeding due to the frequent use of anticoagulant and antiagregant is gradually increasing.The purpose of this study is to determine the effects of especially new-generation anticoagulants on nose bleeding. In addition, the use and complications of new-generation anticoagulants and antiagregants have been compiled in light of information obtained from the literature...
October 14, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27750177/fondaparinux-for-intra-and-perioperative-anticoagulation-in-patients-with-heparin-induced-thrombocytopenia-candidates-for-peripheral-vascular-surgery-report-of-4-cases
#19
Giulio Illuminati, Francesco G Calio', Giulia Pizzardi, Chiara Amatucci, Federica Masci, Piergaspare Palumbo
INTRODUCTION: Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. PRESENTATION OF CASES: Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux...
October 8, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27745616/administration-of-coagulation-altering-therapy-in-the-patient-presenting-for-oral-health-and-maxillofacial-surgery
#20
Thomas M Halaszynski
Oral health care providers are concerned with how to manage patients prescribed coagulation-altering therapy during the perioperative/periprocedural period for dental and oral surgery interventions. Management and recommendation can be based on medication pharmacology and the clinical relevance of coagulation factor levels/deficiencies. Caution should be used with concurrent use of medications that affect other components of the clotting mechanisms; prompt diagnosis and any necessary intervention to optimize outcome is warranted...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
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