Is antithrombotic therapy associated with bleeding or thromboembolic complications in patients undergoing surgery for hepatobiliary and pancreatic malignancy?

2014 ◽  
Vol 219 (4) ◽  
pp. e115
Author(s):  
Takahisa Fujikawa ◽  
Seiichiro Tada ◽  
Yasunori Yoshimoto ◽  
Tomohiro Noda ◽  
Keita Fukuyama ◽  
...  
Keyword(s):  
Antithrombotic Therapy ◽  
Thromboembolic Complications ◽  
Pancreatic Malignancy

scholarly journals Perioperative antithrombotic therapy does not increase the incidence of early postoperative thromboembolic complications and bleeding in kidney transplantation – a retrospective study

2019 ◽  
Vol 32 (4) ◽  
pp. 418-430
Author(s):  
Tamar A. J. Berg ◽  
Robert C. Minnee ◽  
Ton Lisman ◽  
Gertrude J. Nieuwenhuijs‐Moeke ◽  
Jacqueline Wetering ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Retrospective Study ◽  
Antithrombotic Therapy ◽  
Thromboembolic Complications

scholarly journals Double Antithrombotic versus Triple Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndrome

2020 ◽  
Vol 29 (02) ◽  
pp. 081-087
Author(s):  
Surya Dharma
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Vitamin K ◽  
Antithrombotic Therapy ◽  
Randomized Clinical Trials ◽  
Bleeding Event ◽  
Vitamin K Antagonist ◽  
Thromboembolic Complications ◽  
Coronary Syndrome ◽  
Triple Antithrombotic Therapy

AbstractIn atrial fibrillation (AF), oral anticoagulant (OAC) therapy with either vitamin K antagonist or non–vitamin K antagonist is used to prevent thromboembolic complications. In patients who presented with acute coronary syndrome (ACS) and were treated by percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces major adverse cardiac events (MACEs) and stent thrombosis. Consequently, in patients with AF who presented with ACS and were treated by PCI, the combination of OAC and DAPT, the so-called triple antithrombotic therapy (TAT) is needed to improve the outcome of the patients. However, the use of TAT increases the risk of bleeding. Several randomized clinical trials and a meta-analysis evaluated the use of TAT and double antithrombotic therapy (DAT) in this population, and DAT is defined as patients who receive combination of one antiplatelet and OAC. In general, the studies demonstrated a reduction in bleeding event in patients who received DAT as compared with TAT, with similar incidence of thromboembolic complications and MACE. To date, there is no established consensus or guideline for the most appropriate combination of antithrombotic agents in patients with AF and ACS who undergo PCI. Tailoring the treatment for each individual is likely the best approach to determine the balance of bleeding risk and ischemic events before starting antithrombotic therapy. Future trials with adequate sample size are needed to find the most appropriate combination of antiplatelet and OAC in patients with AF who presented with ACS and treated by PCI.

Popliteal vein aneurysm: Is it necessary to apply anticoagulants after a surgery?

Phlebologie ◽  
2014 ◽  
Vol 43 (02) ◽  
pp. 89-92
Author(s):  
M. Geremek ◽  
M. Janik ◽  
G. Malek ◽  
K. Ostrowski ◽  
M. Trochimczuk
Keyword(s):  
Literature Review ◽  
Antithrombotic Therapy ◽  
Predisposing Factors ◽  
Popliteal Vein ◽  
Venous Aneurysm ◽  
Thromboembolic Complications ◽  
Thromboembolic Risk ◽  
Repeat Assessment ◽  
Tangential Resection

SummaryAim: This study is intended to evaluate indications for antithrombotic therapy in patients with tangentially resected popliteal vein aneurysm.Methods: Evaluation of the course of therapy in a patient with popliteal vein aneurysm. Literature review covered literature data published within the last decade. Studies were identified by searching Medline and PubMed databases for the following phrases: ”popliteal venous aneurysm” and ”popliteal vein aneurysm”.Results: The case study and literature review revealed that thromboembolic risk cannot be entirely eliminated by means of tangential resection of popliteal vein aneurysm. Vein suture and residual postoperative dilatation of the popliteal vein can be considered predisposing factors to thromboembolic complications.Conclusion: Patients with tangentially resected popliteal vein aneurysm involving vein suture can be administered oral antithrombotic therapy within three months postoperatively. Therapy extension should be made conditional on the degree of vein dilation reduction. Where the diameter at surgical site is larger than 20 mm, it appears appropriate to continue antithrombotic therapy and to repeat assessment in six months time.

scholarly journals Assessment of Antithrombotic Therapy in Patients with Atrial Fibrillation for 2015-2017 According to the Registry of the Clinic of the Scientific Research Institute of Medical Problems of the North of Krasnoyarsk City

2019 ◽  
Vol 15 (1) ◽  
pp. 43-48
Author(s):  
A. A. Tuchkov ◽  
N. G. Gogolashvili ◽  
R. A. Yaskevich
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Antithrombotic Therapy ◽  
Heart Valves ◽  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
Thromboembolic Complications ◽  
Medical Problems ◽  
The North ◽  
Cardiology Department

Aim. To evaluate the volume of antithrombotic therapy (ATT) at the prehospital stage in connection with the risk of thromboembolic complications, and also to study the dynamics of the frequency of administration of oral anticoagulants (ОAC) in patients with atrial fibrillation (AF) in 2015-2017.Material and methods. The registry included 562 patients with AF at the age of 18 years and older, hospitalized in the cardiology department during 2015-2017. The registry did not include patients with AF and mechanical heart valves, mitral stenosis. The diagnosis of AF was established in accordance with the current recommendations. All patients had an assessment of the risk of thromboembolic complications on the CHA2DS2-VASc scale, the risk of bleeding on the HAS-BLED scale. The incidence of ATT at the prehospital stage was assessed depending on the risk of thromboembolic complications based on patient questioning and analysis of medical records. In addition, an assessment of the dynamics of the frequency of the OAC prescription during 2015-2017 was conducted.Results. The overwhelming majority of patients with AF (96.1%) belonged to the group of high-risk of cardioembolic strokes according to the CHA2DS2-VASc scale and had indications for OAC therapy. The frequency of OAC prescription in patients with AF who were admitted to the cardiology department was 32% at the prehospital stage, of which 19.8% of patients took warfarin and 12.2% – direct OAC. The target level of the international normalized ratio (from 2.0 to 3.0) at the time of hospitalization was observed only in 33.6% of patients taking warfarin. Over the observation period, there was a tendency to increase the frequency of OAC prescription from 30% in 2015 to 38.4% in 2017.Conclusion. Only 32% of patients with AF and high risk of thromboembolic complications received adequate antithrombotic therapy at the prehospital stage. According to the registry the frequency of OAC prescription in patients with AF during 2015-2017 increased by 8.4%. At the same time, there was a significant increase in the frequency of direct OAC prescription. 

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

2016 ◽  
Vol 34 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Jun Ishida ◽  
Takumi Fukumoto ◽  
Masahiro Kido ◽  
Ippei Matsumoto ◽  
Tetsuo Ajiki ◽  
...  
Keyword(s):  
Antithrombotic Therapy ◽  
Pancreatic Surgery ◽  
Thromboembolic Complications

Long-term Antithrombotic Therapy for the Prevention of Thromboembolic Complications in Patients With Chronic Heart Failure

Kardiologiia ◽  
2014 ◽  
Vol 6_2014 ◽  
pp. 86-90 ◽  
Author(s):  
Yu.F. Osmolovskaya Osmolovskaya ◽  
N.V. Romanova Romanova ◽  
I.V. Fats Fats ◽  
S.N. Tereshtchenko Tereshtchenko ◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Antithrombotic Therapy ◽  
Thromboembolic Complications

scholarly journals Safety of Inguinal Hernia Repair in the Elderly with Perioperative Continuation of Antithrombotic Therapy

2020 ◽  
pp. 1-8
Author(s):  
Gonish Hada ◽  
Sen Zhang ◽  
Yinghan Song ◽  
Mukesh Jaiswar ◽  
Yanyan Xie ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Antithrombotic Therapy ◽  
The Elderly ◽  
Control Group ◽  
Thromboembolic Complications ◽  
Primary Endpoints ◽  
Hemorrhagic Complications ◽  
Postoperative Length

<b><i>Introduction:</i></b> This study aimed to evaluate the safety of an inguinal hernia repair (IHR) under local anesthesia (LA) in the elderly with a perioperative continuation of antithrombotic therapy (AT). <b><i>Methods:</i></b> A total of 120 patients undergoing elective primary IHR between August 2018 and August 2019 at the West China Hospital of China were prospectively studied, among which 60 patients also had coexisting cardiovascular diseases and had a continuation of AT perioperatively (antithrombotic group); the other 60 patients were not on any prior AT (control group). The primary endpoints were intra- and postoperative hemorrhagic complications, the required interventions for complications based on the Clavien-Dindo classification, and postoperative thromboembolic complications. The secondary endpoints were nonhemorrhagic complications, intraoperative duration, and postoperative length of stay (LOS). <b><i>Results:</i></b> None of the patients in both groups had significant intraoperative bleeding &#x3e;10 mL, and there were no significant differences between the 2 groups in terms of the postoperative hemorrhagic complications: bruising (2 vs. 0%, <i>p</i> = 1.000), serosanguinous soakage (7 vs. 3%, <i>p</i> = 0.679), and no hematoma was observed. Interventions required for encountered complications based on the Clavien-Dindo classification grade I (7 vs. 5%, <i>p</i> = 1.000) were assessed. There were no episodes of postoperative thromboembolic complications within 60 days in both groups. There were also no significant differences between the 2 groups in terms of nonhemorrhagic complications, intraoperative duration, and postoperative LOS (<i>p</i> &#x3e; 0.05 in all). <b><i>Conclusions:</i></b> The perioperative continuation of AT did not increase the risk of intra- and postoperative hemorrhagic complications following IHR in the elderly. Thus, IHR under LA seems to be safe and feasible in this setting.

Antiphospholipid antibody syndrome

Hematology ◽  
2009 ◽  
Vol 2009 (1) ◽  
pp. 233-239 ◽  
Author(s):  
Wendy Lim
Keyword(s):  
Antiphospholipid Antibodies ◽  
Antithrombotic Therapy ◽  
Vitamin K Antagonists ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Thromboembolic Complications ◽  
Limited Data ◽  
Antithrombotic Agents ◽  
Thrombotic Risk ◽  
Pregnancy Morbidity

Abstract The antiphospholipid antibody syndrome (APS) is defined by the persistent presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity. Anti-thrombotic therapy is the mainstay of treatment given the high risk of recurrent thromboembolism that characterizes this condition. Despite the prothrombotic nature of APS, thrombocytopenia is present in a proportion of patients. which can complicate management and limit the use of antithrombotic therapy. The mechanism of APS-associated thrombocytopenia is multifactorial and its relation to thrombotic risk poorly characterized. However, the presence of thrombocytopenia does not appear to reduce thrombotic risk in patients with APS, who can develop thromboembolic complications necessitating antithrombotic treatment. In these cases, treatment of the thrombocytopenia may be necessary to facilitate administration of antithrombotic agents. Clinical trials have demonstrated that patients with antiphospholipid antibodies and venous thromboembolism should be treated with vitamin K antagonists (warfarin); that ischemic stroke may be treated with aspirin or warfarin; and that women with recurrent pregnancy loss should receive prophylactic-dose heparin and aspirin. However, application of these trial results to patients with APS-associated thrombocytopenia can be challenging since there are limited data on the optimal use of antithrombotic agents in this setting. Issues such as determining the platelet threshold at which antithrombotic agents can be safely used and managing patients with both bleeding and thromboembolic complications remain unresolved. Ultimately the risks and benefits of antithrombotic therapy, balanced against the severity of the thrombocytopenia and its potential bleeding risks, need to be assessed using an individualized patient approach.

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