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Perioperative aspirin

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https://www.readbyqxmd.com/read/28089600/perioperative-aspirin-in-cardiac-and-noncardiac-surgery
#1
REVIEW
Jordan E Goldhammer, Corey R Herman, Jian-Zhong Sun
No abstract text is available yet for this article.
October 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#2
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28024656/validation-of-bleeding-classifications-in-coronary-artery-bypass-grafting
#3
Debora Brascia, Daniel Reichart, Francesco Onorati, Andrea Perrotti, Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Ciro Bancone, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Giuseppe Faggian, Tuomas Tauriainen, Eeva-Maija Kinnunen, Francesco Nicolini, Tiziano Gherli, Stefano Rosato, Fausto Biancari
Perioperative bleeding is a determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but there is a lack of adequate stratification of its severity. The ability of the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Study of Platelet Inhibition and Patient Outcomes (PLATO), Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes (CURRENT-OASIS 7), Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events (ESSENCE), and SafeTy and Efficacy of Enoxaparin in Percutaneous coronary intervention patients, an internationaL randomized Evaluation (STEEPLE) bleeding classifications to predict early mortality, stroke, acute kidney injury (AKI) stage 3, and deep sternal wound infection/mediastinitis was investigated in 3,730 patients from the prospective, multicentre E-CABG registry...
December 3, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28007881/platelet-function-recovery-after-ticagrelor-withdrawal-in-patients-awaiting-urgent-coronary-surgery
#4
Emma C Hansson, Carl Johan Malm, Camilla Hesse, Björn Hornestam, Mikael Dellborg, Helena Rexius, Anders Jeppsson
OBJECTIVE: Dual antiplatelet therapy with ticagrelor and aspirin is associated with an increased risk of perioperative bleeding complications. Current guidelines recommend therefore discontinuation of ticagrelor 5 days before surgery to allow sufficient recovery of platelet function. It is not known how the time to recovery varies between individual patients after discontinuation of ticagrelor. METHODS: Twenty-five patients accepted for urgent coronary artery bypass surgery and treated with ticagrelor and aspirin were included in a prospective observational study...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27889960/current-management-in-transurethral-therapy-of-benign-prostatic-obstruction-in-patients-on-oral-anticoagulation-a-worldwide-questionnaire
#5
Benedikt Becker, 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...
January 5, 2017: 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
#6
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/27871515/perioperative-antiplatelet-therapy-and-cardiovascular-outcomes-in-patients-undergoing-joint-and-spine-surgery
#7
Nathaniel R Smilowitz, Brandon S Oberweis, Swetha Nukala, Andrew Rosenberg, Steven Stuchin, Richard Iorio, Thomas Errico, Martha J Radford, Jeffrey S Berger
STUDY OBJECTIVE: Perioperative thrombotic complications after orthopedic surgery are associated with significant morbidity and mortality. The use of aspirin to reduce perioperative cardiovascular complications in certain high-risk cohorts remains controversial. Few studies have addressed aspirin use, bleeding, and cardiovascular outcomes among high-risk patients undergoing joint and spine surgery. DESIGN/SETTING/PATIENTS: We performed a retrospective comparison of adults undergoing knee, hip, or spine surgery at a tertiary care center during 2 periods between November 2008 and December 2009 (reference period) and between April 2013 and December 2013 (contemporary period)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27846735/perioperative-management-of-dual-anti-platelet-therapy
#8
Tyler D Webster, Prashant Vaishnava, Kim A Eagle
Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. While there is uncertainty about the optimal duration of dual antiplatelet therapy following percutaneous coronary intervention, the new 2016 American College of Cardiology/American Heart Association Guidelines suggest that for patients with stable ischemic heart disease at least six months of such therapy following a drug eluting stent and one month following a bare metal stent should be implemented...
December 2016: Hospital Practice (Minneapolis)
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
#9
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/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#10
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
Background Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. Methods In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here...
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27767060/impact-of-different-antithrombotics-on-the-microcirculation-and-viability-of-perforator-based-ischaemic-skin-flaps-in-a-small-animal-model
#11
Andreas M Fichter, Lucas M Ritschl, Luisa K Robitzky, Stefan Wagenpfeil, David A Mitchell, Klaus-Dietrich Wolff, Thomas Mücke
The effects of antithrombotic drugs on random and free flap survival have been investigated in the past, but the experimental and clinical results are not in agreement. A perforator-based critical ischaemia model was used to evaluate the effects of different perioperatively administered pharmaceutical agents on tissue ischaemia and to assess the potential additional haemorheological or vasodilative effects of antithrombotics on flap microcirculation. Combined laser Doppler flowmetry and remission spectroscopy revealed an increase in certain microcirculation parameters in most groups in comparison with saline controls, and these changes correlated with flap survival...
October 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27755410/the-rate-of-epistaxis-incidence-in-new-generation-anticoagulants-and-perioperative-approach-in-otorhinolaryngological-practices
#12
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/27726853/frequency-of-increase-in-cardiac-troponin-levels-after-peripheral-arterial-operations-carotid-endarterectomy-abdominal-aorta-procedure-distal-bypass-and-their-effect-on-medical-management
#13
Yader Sandoval, Marina Zakharova, Thomas S Rector, Emmanouil S Brilakis, Todd Drexel, Edward O McFalls, Santiago Garcia
The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27702830/what-is-the-impact-of-preoperative-aspirin-administration-on-patients-undergoing-coronary-artery-bypass-grafting
#14
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether continuation of administration of preoperative aspirin until the day of coronary artery bypass grafting (CABG) could minimize postoperative mortality, prevalence of postoperative myocardial infarction (MI) with or without influence on postoperative bleeding, packed red blood cell (PRBC) transfusion and reoperation for bleeding. Altogether, 662 papers were found using the reported search, 7 of which represented the best evidence to answer the clinical question...
October 4, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27669654/impact-of-anticoagulant-and-antiplatelet-drugs-on-perioperative-outcomes-of-robotic-assisted-partial-nephrectomy
#15
Benjamin Pradere, Benoit Peyronnet, Thomas Seisen, Zineddine Khene, Marina Ruggiero, Christophe Vaessen, Grégory Verhoest, Romain Mathieu, Morgan Roupret, Karim Bensalah
OBJECTIVE: To evaluate the impact of anticoagulant (AC) or antiplatelet (AP) therapy on the morbidity of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: From 2011 to 2015, we retrospectively analyzed a prospectively maintained institutional review board-approved database of RAPN from 2 academic departments of urology. We evaluated the occurrence of overall complications and hemorrhagic complications (pseudoaneurysm, arteriovenous fistula, hematoma, transfusion)...
January 2017: Urology
https://www.readbyqxmd.com/read/27663179/clinical-outcomes-associated-with-per-operative-discontinuation-of-aspirin-in-patients-with-coronary-artery-disease-a-systematic-review-and-meta-analysis
#16
Faraz Khan Luni, Haris Riaz, Abdur Rahman Khan, Talha Riaz, Muhammad Husnain, Irbaz Bin Riaz, Muhammad Shahzeb Khan, Mohammed Taleb, Yusuf Kanjwal, Christopher J Cooper, Sadik A Khuder
BACKGROUND: Postoperative state is characterized by increased thrombotic risk by virtue of platelet activation. Whether aspirin ameliorates this risk in patients with established coronary artery disease undergoing cardiac or noncardiac surgery is unknown. We conducted a systematic review and meta-analysis to compare the risk of major adverse cardiac events (MACE) and the risk of bleeding in patients with early (3-5 or more days before surgery) vs. late discontinuation(<3-5 days)/no discontinuation of aspirin...
September 24, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27627817/perioperative-aspirin-for-prevention-of-venous-thromboembolism-the-perioperative-ischemia-evaluation-2-trial-and-a-pooled-analysis-of-the-randomized-trials
#17
John W Eikelboom, Clive Kearon, Gordon Guyatt, Daniel I Sessler, Salim Yusuf, Deborah Cook, James Douketis, Ameen Patel, Andrea Kurz, Rene Allard, Philip M Jones, Rodolfo J Dennis, Thomas W Painter, Sergio D Bergese, Kate Leslie, Duminda N Wijeysundera, Kumar Balasubramanian, Emmanuelle Duceppe, Scott Miller, Johan Diedericks, P J Devereaux
BACKGROUND: The PeriOperative ISchemia Evaluation-2 (POISE-2) trial compared aspirin with placebo after noncardiac surgery. METHODS: The authors randomly assigned 10,010 patients undergoing noncardiac surgery to receive 200 mg aspirin or placebo 2 to 4 h before surgery and then 100 mg aspirin daily or placebo daily for up to 30 days after surgery. Herein, the authors report the effect of aspirin on venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, as well as an updated pooled analysis of randomized trials of antiplatelet therapy for VTE prevention in noncardiac surgery patients...
September 14, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27614827/evaluating-blood-loss-and-the-effect-of-antiplatelet-treatment-in%C3%A2-foot%C3%A2-and-ankle-amputations
#18
David Schweer, Jonathon J Carmouche, Daniel Jupiter, Timothy Ball, J Randolph Clements
The interrelationship between diabetes mellitus and cardiovascular disease is well-documented, and, secondary to the latter, is the use of antiplatelet therapy. Although diabetes and the associated vascular manifestations are driving forces behind lower extremity amputations, few data are available on the risks of perioperative antiplatelet therapy with foot and ankle amputations. The goal of the present study was to address the surgical effect of continuing or discontinuing antiplatelet therapy before foot and/or ankle amputation...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27613165/comparison-of-preoperative-continuation-and-discontinuation-of-aspirin-in-patients-undergoing-total-hip-or-knee-arthroplasty
#19
Rahel Meier, Regula Marthy, Christoph H Saely, Markus S Kuster, Karlmeinrad Giesinger, Hans Rickli
INTRODUCTION: Preoperative discontinuation of aspirin (acetylsalicylic acid) can reduce bleeding risk but may increase the risk of perioperative cardiovascular events. MATERIALS AND METHODS: We retrospectively assessed the impact of preoperative continuation versus discontinuation of aspirin compared with a control group in a cohort of 739 consecutive patients undergoing total hip (THA) (n = 396) or knee arthroplasty (TKA) (n = 343) at a tertiary hospital. Bleeding risk, local complications, orthopaedic outcome, and cardiac and cerebral complications were assessed...
December 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27555160/a-retrospective-study-showing-the-extent-of-compliance-with-perioperative-guidelines-in-patients-with-coronary-stents-with-regard-to-double-antiplatelet-therapy
#20
Austin A Woolard, Jesse M Ehrenfeld, Susan S Eagle, Jonathan P Wanderer
STUDY OBJECTIVE: To evaluate perioperative dual antiplatelet therapy management in patients with previously placed coronary stents. DESIGN: Retrospective medical record review. SETTING: Academic medical center. PATIENTS: A total of 1891 surgical cases performed at Vanderbilt University Medical Center in 2012 were evaluated using a perioperative database. Of these, 161 had complete data records that were evaluated using 2 evidence-based and expert opinion-supported protocols...
September 2016: Journal of Clinical Anesthesia
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