Key result
Continuing antithrombotic therapy during low-risk dental interventions does not require interruption, as local hemostatic measures are sufficient to manage bleeding complications.
Why the study?
How should antithrombotic agents be managed in patients undergoing oral surgery to balance bleeding and thrombotic risks?
How should antithrombotic agents be managed in patients undergoing oral surgery to balance bleeding and thrombotic risks?
Patients on antithrombotic therapy undergoing low-bleeding-risk dental procedures do not require interruption of their medication, as local hemostatic measures are generally sufficient to manage bleeding.
Supports continuing antithrombotics without interruption in low-risk dental procedures; leaves open need for prospective validation.
Systemic anticoagulation with intravenous or oral anticoagulants and antiplatelet agents is an efficient treatment against thromboembolic or cardiovascular disease. Invasive dental procedures or oral surgery might be associated with bleeding complications if carried out under anticoagulants. Patients on vitamin K antagonists, new direct anticoagulants or antiplatelet agents having dental interventions with low-risk for bleeding do not need interruption of anticoagulation. In case of bleeding complications local hemostatic measures, such as local surgical sutures, fibrin glue, local antifibrinolytic treatment with tranexamic acid, or e-aminocaproic acid suffice to stop bleeding. In patients with high risk of bleeding an individual assessment of the benefit/risk ratio of interrupting anticoagulation should be carried out. Bridging the long-term anticoagulation with short-term anticoagulants should be planned according to national or international guidelines. The introduction of the newer direct oral anticoagulants having more flexible pharmacokinetic properties has facilitated bridging, allowing short-term interruption without increasing the risk of relapsing thrombotic or cardiovascular events.
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Martínez et al. (2015) conducted a review in Patients on antithrombotic agents undergoing oral surgery. Management of antithrombotic agents was evaluated. Continuing antithrombotic therapy during low-risk dental interventions does not require interruption, as local hemostatic measures are sufficient to manage bleeding complications.
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