Key result
Perioperative antithrombotic management requires balancing the risk of periprocedural bleeding with continued treatment against the thrombotic risk with suspension of treatment and use of bridging.
Perioperative management of antithrombotic therapy requires careful, individualized risk stratification for both thromboembolism and bleeding to guide decisions on therapy interruption and bridging.
Demands individualized perioperative antithrombotic decisions; leaves open optimal bridging strategies for prospective trials.
Antithrombotic therapy (Warfarin, Aspirin,Clopidogrel etc.) are routinely used in prevention and treatment of various cardiovascular diseases. In patients who are having a surgical or other invasive procedure, interruption of antithrombotic therapy is typically required to minimize the risk for perioperative bleeding. It involves balancing the risk of periprocedural bleeding with continued treatment against the thrombotic risk with suspension of treatment and use of bridging anticoagulation therapy. The need for bridging is driven by patients estimated risk for thromboembolism and the bleeding risk of invasive procedure. Treatment with subcutaneous low-molecular- weight heparin or intravenous unfractionated heparin at a therapeutic dose before and after the procedure recommended as bridging anticoagulation therapy. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19511 University Heart Journal Vol. 9, No. 1, January 2013; 47-51
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Hasan et al. (2014) conducted a review in Patients on antithrombotic therapy undergoing surgical or invasive procedures. Perioperative antithrombotic management was evaluated. Perioperative antithrombotic management requires balancing the risk of periprocedural bleeding with continued treatment against the thrombotic risk with suspension of treatment and use of bridging.
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