Pictorial Essay. CT of Hemorrhagic Complications of Anticoagulant Therapy

1997 ◽  
Vol 21 (1) ◽  
pp. 44-51 ◽  
Author(s):  
E. Scott Pretorius ◽  
Elliot K. Fishman ◽  
S. James Zinreich
Keyword(s):  
Anticoagulant Therapy ◽  
Hemorrhagic Complications ◽  
Pictorial Essay

Hemorrhagic Complications of Long-term Anticoagulant Therapy

CHEST Journal ◽  
1989 ◽  
Vol 95 (2) ◽  
pp. 26S-36S ◽  
Author(s):  
Mark N. Levine ◽  
Gary Raskob ◽  
Jack Hirsh
Keyword(s):  
Anticoagulant Therapy ◽  
Hemorrhagic Complications

Prevention of Hemorrhagic Complications After Dental Extractions Into Open Heart Surgery Patients Under Anticoagulant Therapy: The Use of Leukocyte- and Platelet-Rich Fibrin

2011 ◽  
Vol 37 (6) ◽  
pp. 681-690 ◽  
Author(s):  
Gilberto Sammartino ◽  
David M. Dohan Ehrenfest ◽  
Francesco Carile ◽  
Mariano Tia ◽  
Paolo Bucci
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Heart Surgery ◽  
Therapeutic Option ◽  
Oral Anticoagulant Therapy ◽  
Open Heart Surgery ◽  
Filling Material ◽  
Platelet Rich Fibrin ◽  
Delayed Bleeding ◽  
Hemorrhagic Complications

Leukocyte- and platelet-rich fibrin (L-PRF) is a biomaterial commonly used in periodontology and implant dentistry to improve healing and tissue regeneration, particularly as filling material in alveolar sockets to regenerate bone for optimal dental implant placement. The objective of this work was to evaluate the use of L-PRF as a safe filling and hemostatic material after dental extractions (or avulsions) for the prevention of hemorrhagic complications in heart surgery patients without modification of the anticoagulant oral therapy. Fifty heart surgery patients under oral anticoagulant therapy who needed dental extractions were selected for the study. Patients were treated with L-PRF clots placed into 168 postextraction sockets without modification of anticoagulant therapy (mean international normalized ratio  =  3.16 ± 0.39). Only 2 patients reported hemorrhagic complications (4%), all of which resolved a few hours after the surgery by compression and hemostatic topical agents. Ten patients (20%) showed mild bleeding, which spontaneously resolved or was resolved by minimal compression less than 2 hours after surgery. No case of delayed bleeding was reported. The remaining 38 patients (76%) showed an adequate hemostasis after the dental extractions. In all cases, no alveolitis or painful events were reported, soft tissue healing was quick, and wound closure was always complete at the time of suture removal one week after surgery. The proposed protocol is a reliable therapeutic option to avoid significant bleeding after dental extractions without the suspension of the continuous oral anticoagulant therapy in heart surgery patients. Other applications of the hemostatic and healing properties of L-PRF should be investigated in oral implantology.

scholarly journals Incidence of complications of antithrombotic treatment in patients with atrial fibrillation

2013 ◽  
Vol 66 (11-12) ◽  
pp. 470-475
Author(s):  
Sladjana Novakovic-Anucin ◽  
Sanja Gnip ◽  
Visnja Canak ◽  
Pavica Radovic ◽  
Jelena Kovacev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Oral Anticoagulant Therapy ◽  
Vitamin K Antagonists ◽  
Combined Treatment ◽  
Thromboembolic Complications ◽  
Antithrombotic Treatment ◽  
Hemorrhagic Complications

Introduction. Atrial fibrillation increases the risk of ischemic stroke five fold, while the application of long-term anticoagulant therapy is associated with the occurrence of hemorrhagic complications. The aim of our study was to evaluate the incidence of thrombotic and hemorrhagic complications in patients with atrial fibrillation during antithrombotic treatment. Material and Methods. The study included 504 patients that were administered the primary (n=345) or secondary thromboprophylaxis after ischemic stroke (n=159), by applying vitamin K antagonists, or the combination of vitamin K antagonists and low-dose aspirin. The patients were followed for five months in the period of 24 years from 1988 to 2012, the total number of patient?s years being 1884, at the Clinical Center of Vojvodina. Thromboembolic and hemorrhagic complications were registered during regular check-up examinations. Results and Discussion. Our results indicate the low incidence of thromboembolic complications (0.01 patient per a year), with a lower incidence in the vitamin K antagonists group than in the group with the combination of vitamin K antagonists and aspirin (0.008 patient per a year versus 0.01 patient per a year). The incidence of hemorrhagic complications was higher in the group with the combined treatment compared to the group treated with vitamin K antagonists (0.1 patient per a year versus 0.06 patient per a year). The frequency of major bleeding was as low as 0.01 patient per a year and more frequent in the group with combined treatment (0.03 patient per a year). Conclusion. The overall incidence of complications in the study group was 0.08 patient per a year. The combined antithrombotic treatment increases the risk of hemorrhagic complications and affects the severity of bleeding. Oral anticoagulant therapy is more efficient in the prevention of ischemic stroke and thromboembolic complications in patients with atrial fibrillation.

scholarly journals The use of low molecular weight heparins in patients with acute ST-elevated myocardial infarction

2006 ◽  
Vol 59 (9-10) ◽  
pp. 476-481 ◽  
Author(s):  
Milovan Petrovic ◽  
Gordana Panic ◽  
Tibor Canji ◽  
Ilija Srdanovic ◽  
Vladimir Ivanovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Molecular Weight ◽  
Unfractionated Heparin ◽  
Anticoagulant Therapy ◽  
Fibrinolytic Therapy ◽  
Low Molecular Weight ◽  
Cardiac Events ◽  
Low Molecular Weight Heparins ◽  
Adverse Cardiac Events ◽  
Hemorrhagic Complications

Introduction. According to the published guidelines for the management of acute coronary syndromes (ACS), treatment of acute ST-elevated myocardial infarction is based on rapid revascularization, either mechanical or pharmacological. Pharmacological revascularization consists of fibrinolytic therapy with antiplatelet and anticoagulant therapy. In regard to the anticoagulant therapy, low molecular weight heparins (LMWHs) are of special importance. LMWHs cause less complications (bleeding, thrombocytopenia, better bioviability) in comparison with unfractionated heparin (UFH). Some studies on use of LMWHs in ACS, show that LMWHs are equally efficient and safe as UFH, causing less complications (different types of hemorrhagic complications) (ESSENCE, TIMI 11B (enoxaparin), FRAXIS - fraxiparin), whereas some studies show better efficacy and safety of enoxaparin in therapy of acute ST-elevated myocardial infarction (ASSENT 3, ASSENT 3 PLUS, HART II, AMI-SK). Material and methods. Inclusion criteria: acute anterior myocardial infarction with ST-elevation, first myocardial infarction, no other structural heart defects, no signs of cardiogenic shock. Our study included 30 patients receiving fibrinolytic therapy with streptokinase, antiplatelet therapy and LMWH during 6 days, and 30 patients receiving UFH instead of LMWH. The follow-up period lasted for 6 months. Results. Significantly more patients receiving unfractionated heparin presented with major adverse cardiac events (73.3%) in regard to patients in the study group (44,2% nadroparin, 39.8% enoxaparin) (p=0.025). In the group receiving UFH, 6.7% patients had hemorrhagic complications, while none of patients receiving LMWHs. An equal number of patients died. Conclusion. Patients who were treated with LMWHs experienced less major adverse cardiac events and lower mortality. None suffered from hemorrhagic complications. .

scholarly journals Combined Prevention of Thrombosis and Hemorrhagic Complications in Patients after Replacement of the Knee or Hip Joint

Biomeditsina ◽  
2020 ◽  
Vol 16 (3) ◽  
pp. 81-85
Author(s):  
L. S. Golovko ◽  
A. V. Safronenko ◽  
E. V. Gantsgorn ◽  
N. V. Sukhorukova ◽  
E. S. Postnikova ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Anticoagulant Therapy ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Time Interval ◽  
Prevention Of Thrombosis ◽  
Hemorrhagic Complications ◽  
Knee And Hip Arthroplasty

The article demonstrates the importance of observing the time interval between hemostatic and anticoagulant therapy for at least 18 hours, particularly when using tranexamic acid as a hemostatic drug. The developed complications of a thrombotic and hemorrhagic nature in the early postoperative period after knee and hip arthroplasty were analyzed. Schemes of hemostatic and anticoagulant agents, which developed thrombosis and hemorrhagic complications, were also determined.

Anticoagulant therapy in patients with atrial fibrillation: management of bleeding

2021 ◽  
Vol 27 (1) ◽  
pp. 57-65
Author(s):  
Irina V. Zotova
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Common Complication ◽  
Thromboembolic Risk ◽  
Hemorrhagic Complications

Bleeding is the most common complication of long-term anticoagulant therapy. For patients with atrial fibrillation, it is important to consider the balance of hemorrhagic and thromboembolic risks in the event of bleeding since unreasonable withdrawal of anticoagulants can worsen the prognosis. The management of patients with hemorrhagic complications is determined according to the severity of bleeding, type of anticoagulant taken, and presence of high thromboembolic risk factors. The paper presents the authors protocol for the management of patients with atrial fibrillation and various types of hemorrhagic complications against the background of anticoagulant therapy.

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