Key result
Perioperative interruption of antiplatelet medications before elective spine surgery is a common practice lacking evidence-based guidelines, which may increase the risk of cardiovascular syndromes.
Why the study?
Does perioperative withdrawal of antiplatelet medications increase the risk of cardiovascular syndromes in patients undergoing elective extradural non-instrumented spine surgery?
Does perioperative withdrawal of antiplatelet medications increase the risk of cardiovascular syndromes in patients undergoing elective extradural non-instrumented spine surgery?
The common practice of withdrawing antiplatelets before elective spine surgery to avoid hemorrhagic risks may inadvertently increase perioperative cardiovascular risks.
It is more and more frequent that patients taking antiplatelets for cardiac, cerebral or peripheral vascular diseases are referred for spine surgery. Even though there are not guidelines, the most common attitude in Italy is suggesting antiplatelets withdrawal at least 5-7 days before surgery. This is mainly due to fear of legal controversies, rather than evidence-based data on higher hemorrhagic risks. On the other hand, several studies questioned this attitude reporting perioperative increased risks of cardiovascular syndromes in patients discontinuing antiplatelets, due to increased endogenous catecholamines, platelet adhesiveness and decreased fibrinolysis.1
No takes yet. Share an insight, caveat, or question.
Ricciardi et al. (2021) conducted an editorial in Patients taking antiplatelets for cardiac, cerebral or peripheral vascular diseases referred for spine surgery. Perioperative interruption of antiplatelet medications was evaluated. Perioperative interruption of antiplatelet medications before elective spine surgery is a common practice lacking evidence-based guidelines, which may increase the risk of cardiovascular syndromes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: