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Perioperative aspirin

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https://www.readbyqxmd.com/read/29016553/bleeding-and-neurologic-complications-in-58-000-interventional-pain-procedures
#1
Nafisseh S Warner, W Michael Hooten, Matthew A Warner, Tim J Lamer, Jason S Eldrige, Halena M Gazelka, Daryl J Kor, Bryan C Hoelzer, William D Mauck, Susan M Moeschler
BACKGROUND AND OBJECTIVES: Interventional pain procedures are commonly performed on patients receiving antiplatelet therapy. However, there is limited evidence to support or refute the safety of this practice. The goal of this investigation was to assess the rate of bleeding complications in a large cohort of patients undergoing intermediate- and low-risk pain procedures, with a specific focus on antiplatelet and anticoagulant medication use and baseline coagulation abnormalities. METHODS: This is a retrospective cohort study of adult patients undergoing low- and intermediate-risk pain procedures from 2005 through 2014 by the division of pain medicine at a single academic tertiary care center...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28927346/deep-venous-thrombosis-prophylaxis-in-anterior-cruciate-ligament-reconstructive-surgery-what-is-the-current-state-of-practice
#2
Robert A Keller, Vasilios Moutzouros, Joshua S Dines, Charles A Bush-Joseph, Orr Limpisvasti
BACKGROUND: Venous thromboembolism (VTE) is a significant perioperative risk with many common orthopaedic procedures. Currently, there is no standardized recommendation for the use of VTE prophylaxis during anterior cruciate ligament (ACL) reconstruction. This study sought to evaluate the current prophylactic practices of fellowship-trained sports medicine orthopaedic surgeons in the United States. HYPOTHESIS: Very few surgeons use perioperative VTE prophylaxis for ACL reconstructive surgery...
September 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28919069/impact-of-discontinuation-of-antiplatelet-therapy-prior-to-isolated-valve-and-combined-coronary-artery-bypass-graft-and-valve-procedures-on-short-and-intermediate-term-outcomes
#3
James Meneguzzi, Matthew Kilpin, Ying Yan Zhu, Atsuo Doi, Christopher Reid, Lavinia Tran, Philip Hayward, Julian Smith
BACKGROUND: A change in cardiac surgery practice over the past decade has seen an increase in urgent or inpatient referrals for surgery, with antiplatelet therapy often continued up until surgery. This study aims to identify the optimal timing for administration of aspirin to minimise risk of perioperative morbidity and mortality. METHODS: From a prospectively compiled database collected by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, we identified 8,294 patients undertaking combined CABG and valve or isolated valve procedures while discontinuing aspirin...
September 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28874960/impact-of-laparoscopic-liver-resection-on-bleeding-complications-in-patients-receiving-antithrombotics
#4
Takahisa Fujikawa, Hiroshi Kawamoto, Yuichiro Kawamura, Norio Emoto, Yusuke Sakamoto, Akira Tanaka
AIM: To assess the impact of laparoscopic liver resection (LLR) on surgical blood loss (SBL), especially in patients with antithrombotics for thromboembolic risks. METHODS: Consecutive 258 patients receiving liver resection at our institution between 2010 and 2016 were retrospectively reviewed. Preoperative antithrombotic therapy (ATT; antiplatelets and/or anticoagulation) was regularly used in 100 patients (ATT group, 38.8%) whereas not used in 158 (non-ATT group, 61...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28863955/an-umbrella-arrives-toward-the-end-of-the-storm-patient-tailored-aspirin-dosing-improves-late-perioperative-thromboprophylaxis
#5
EDITORIAL
David Bichell, Muhammad A Raees
No abstract text is available yet for this article.
July 29, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28856946/spontaneous-hit-syndrome-post-knee-replacement-surgery-with-delayed-recovery-of-thrombocytopenia-a-case-report-and-literature-review
#6
Dilli Ram Poudel, Sushil Ghimire, Rashmi Dhital, Daniel A Forman, Theodore E Warkentin
Recently published reports have established a heparin-induced thrombocytopenia (HIT)-mimicking thromboembolic disorder without proximate heparin exposure, called spontaneous HIT syndrome. Although the pathophysiology remains unclear, anti-platelet factor 4 (PF4)/heparin antibodies possibly triggered by exposure to knee cartilage glycosaminoglycans or other non-heparin polyanions found on bacterial surfaces and nucleic acids have been postulated. We present a 53-year-old female receiving antithrombotic prophylaxis with aspirin following right total knee replacement surgery (without perioperative or any previous lifetime heparin exposure) who acutely presented with high-risk pulmonary embolism (PE) and right great saphenous vein thrombophlebitis on postoperative day (POD) 14; her platelet count at presentation was 13 × 10(9)/L...
September 2017: Platelets
https://www.readbyqxmd.com/read/28842832/perioperative-management-of-antithrombotic-therapy-in-patients-receiving-cardiovascular-implantable-electronic-devices-a-network-meta-analysis
#7
Hua He, Bing-Bing Ke, Yan Li, Fu-Sheng Han, Xiaodong Li, Yu-Jie Zeng
PURPOSE: Network meta-analysis (NMA) has advantages including being able to simultaneously compare and rank multiple treatments over traditional meta-analysis. We evaluated by a NMA the optimal antithrombotic strategy during the perioperative period of implantation of cardiovascular implantable electronic devices (CIEDs). METHODS: We performed a network meta-analysis of observational studies (cohort and case-control studies). The eligible studies tested the following antithrombotic therapy during the CIED placement: aspirin, clopidogrel, warfarin, novel oral anticoagulants (NOACs), and heparin bridging...
August 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28826848/preoperative-aspirin-does-not-increase-transfusion-or-reoperation-in-isolated-valve-surgery
#8
Jordan E Goldhammer, Corey R Herman, Mark W Berguson, Marc C Torjman, Richard H Epstein, Jian-Zhong Sun
OBJECTIVE: Preoperative aspirin has been studied in patients undergoing isolated coronary artery bypass graft surgery. However, there is a paucity of clinical data available evaluating perioperative aspirin in other cardiac surgical procedures. This study was designed to investigate the effects of aspirin on bleeding and transfusion in patients undergoing non-emergent, isolated, heart valve repair or replacement. DESIGN: Retrospective, cohort study. SETTING: Academic medical center...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#9
REVIEW
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28794832/perioperative-management-and-monitoring-of-antiplatelet-agents-a-focused-review-on-aspirin-and-p2y12-inhibitors
#10
REVIEW
Michael A Mazzeffi, Khang Lee, Bradley Taylor, Kenichi A Tanaka
Platelets play pivotal roles in hemostasis as well as pathological arterial thrombosis. The combination of aspirin and a P2Y12 inhibitor has become the mainstay therapy in the ageing population with cardiovascular conditions, particularly during and after percutaneous coronary intervention. A number of novel P2Y12 inhibitors has become available in the recent years, and they markedly vary in pharmacokinetic and pharmacodynamic properties. Perioperative physicians today face a challenge of preventing hemorrhage due to platelet inhibitors, while minimizing thrombotic risks...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28733910/a-review-study-to-evaluate-holmium-yag-laser-lithotripsy-with-flexible-ureteroscopy-in-patients-on-ongoing-oral-anticoagulant-therapy
#11
Bulent Altay, Bulent Erkurt, Selami Albayrak
The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified...
July 22, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28715503/effects-of-preoperative-aspirin-on-perioperative-platelet-activation-and-dysfunction-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-prospective-randomized-study
#12
RANDOMIZED CONTROLLED TRIAL
Jiwon Lee, Chul-Woo Jung, Yunseok Jeon, Tae Kyong Kim, Youn Joung Cho, Chang-Hoon Koo, Yoon Hyeong Choi, Ki-Bong Kim, Ho Young Hwang, Hang-Rae Kim, Ji-Young Park
The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups...
2017: PloS One
https://www.readbyqxmd.com/read/28677035/symptomatic-carotid-artery-stenosis-surgery-stenting-or-medical-therapy
#13
REVIEW
Ashley M Wabnitz, Tanya N Turan
Symptomatic carotid artery disease is a significant cause of ischemic stroke, and these patients are at high risk for recurrent vascular events. Patients with symptoms of stroke or transient ischemic attack attributable to a significantly stenotic vessel (70-99% luminal narrowing) should be treated with intensive medical therapy. Intensive medical therapy is a combination of pharmacologic and lifestyle interventions consistent with best-known practices as follows: initiation of antiplatelet agent or anticoagulation if medically indicated, high potency statin medication, blood pressure control with goal blood pressure of greater than 140/90, Mediterranean-style diet, exercise, and smoking cessation...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28645644/-antiplatelet-agents-and-transfusion
#14
P Gaussem, A-C Martin, T Belleville-Rolland, D Helley, C Bachelot-Loza, A Godier
Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties...
June 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#15
REVIEW
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28600024/efficacy-of-cilostazol-for-below-the-knee-artery-disease-after-balloon-angioplasty-in-patients-with-severe-limb-ischemia-cabbage-trial
#16
Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Yasutaka Yamauchi, Keisuke Hirano, Masashi Fukunaga, Kan Zen, Kenji Suzuki, Yoshiaki Shintani, Yusuke Miyashita, Taketsugu Tsuchiya, Terutoshi Yamaoka, Kenji Ando
BACKGROUND: Optimal medical therapy after endovascular therapy in patients with critical limb ischemia (CLI) remains unclear. Therefore, we investigated whether cilostazol reduce restenosis after balloon angioplasty for infrapopliteal lesions in CLI patients. METHODS: This study was performed as a multicenter, prospective, randomized, open-label, blinded-end point study with independent angiographic core laboratory adjudication. Sixty patients were eligible and 53 patients were enrolled and allocated...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28587360/the-value-of-sonoclot-detection-technology-to-guide-the-clinical-medication-of-the-perioperative-anticoagulation-and-antiplatelet-therapy-in-patients-with-acute-myocardial-infarction-undergoing-emergent-pci
#17
Wu-Xiao Yang, Chun-Lin Lai, Fu-Heng Chen, Ji-Rong Wang, You-Rui Ji, Dong-Xia Wang
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#18
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28472145/preoperative-aspirin-use-and-acute-kidney-injury-after-cardiac-surgery-a-propensity-score-matched-observational-study
#19
Min Hur, Chang-Hoon Koo, Hyung-Chul Lee, Sun-Kyung Park, Minkyung Kim, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: The association between preoperative aspirin use and postoperative acute kidney injury (AKI) in cardiovascular surgery is unclear. We sought to evaluate the effect of preoperative aspirin use on postoperative AKI in cardiac surgery. METHODS: A total of 770 patients who underwent cardiovascular surgery under cardiopulmonary bypass were reviewed. Perioperative clinical parameters including preoperative aspirin administration were retrieved. We matched 108 patients who took preoperative aspirin continuously with patients who stopped aspirin more than 7 days or did not take aspirin for the month before surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28464540/safety-and-feasibility-of-liver-resection-with-continued-antiplatelet-therapy-using-aspirin
#20
Kazuteru Monden, Hiroshi Sadamori, Masayoshi Hioki, Satoshi Ohno, Hiromi Saneto, Toru Ueki, Kazuhisa Yabushita, Kazumi Ono, Kousaku Sakaguchi, Norihisa Takakura
BACKGROUND: Aspirin is widely used for the secondary prevention of ischemic stroke and cardiovascular disease. Perioperative aspirin may decrease thrombotic morbidity, but may also increase hemorrhagic morbidity. In particular, liver resection carries risks of bleeding, leading to higher risks of hemorrhagic morbidity. Our institution has continued aspirin therapy perioperatively in patients undergoing liver resection. This study examined the safety and feasibility of liver resection while continuing aspirin...
July 2017: Journal of Hepato-biliary-pancreatic Sciences
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