[Perioperative suspension of anticoagulants: practical recommendations].
If patients being treated with anticoagulants need to undergo an operation then physicians need to consider whether to suspend the use of this medication or to allow its use to be continued. Suspending the use of anticoagulants increases the risk of thrombosis, whereas continued use may cause bleeding complications. No evidence-based scientific research has been carried out regarding best practice for the perioperative use of anticoagulants.Antithrombotic drugs are vitamin K antagonists and platelet aggregation inhibitors. For daily practice, appropriate bridging strategies can be used for perioperative anticoagulant policy for various risk groups, such as patients with venous thromboembolism, atrial fibrillations, mechanical heart valves and coronary heart diseases (including coronary stents) and patients who have experienced a cerebrovascular accident. In the vast majority of cases the treating physician must carefully consider each individual case in order to realise the best policy.
Academisch Medisch Centrum/Universiteit van Amsterdam, Afd. Anesthesiologie, Amsterdam, The Netherlands. jasper.s.dejong@amc.uva.nl
Jasper S
JS
de Jong
Roel
R
Vink
Ch Pieter
ChP
Henny
Marcel
M
Levi
Renee B A
RB
van den Brink
Pieter Willem
PW
Kamphuisen
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013927:Thrombosis / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K