Bridge-therapy with enoxaparin in the preoperative period of endarterectomy.
Cervical clot is one of the complications of endarterectomy. This risk may be higher in patients using aspirin or clopidogrel. On the other hand, stroke may occur if the medication is interrupted before surgery. We carried out a prospective study of 124 endarterectomies in 119 patients in which aspirin or clopidogrel was stopped and a bridge-therapy with enoxaparin was administered preoperatively. There was no case of stroke during the period of the bridge-therapy. One patient developed cervical clot (0.8%) in the fifth postoperative day. Mortality rate in this series was 0.8%. There was no complication directly related to the use of enoxaparin. Bridge-therapy with low molecular weight heparin is a safe strategy for patients elected for endarterectomy.
Instituto Mineiro de Neurocirurgia, Biocor Instituto, Belo Horizonte, MG, Brazil.
Jair Leopoldo
JL
Raso
Rogério Zenóbio
RZ
Darwich
Francisco de
Fd
Lucca
Romeu Valle
RV
Santana
Marco Túlio
MT
Tanure
Gustavo Agra
GA
Cariri
Leopoldo Mandic Ferreira
LM
Furtado
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006406:Hematoma / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009333:Neck; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D011446:Prospective Studies
D000925:Anticoagulants; D017984:Enoxaparin