Perioperative management of chronic anticoagulation in orthopaedic surgery.
The orthopaedic patient on chronic anticoagulation therapy is at risk of thromboembolism and hemorrhage in the perioperative period. To establish the most effective anticoagulation regimen, patients should be stratified according to the risk of arterial or venous thromboembolism. Timing of surgery, thromboembolic risk, and bleeding risk should be considered when developing an anticoagulation protocol. Retrievable inferior vena cava filters may be a viable alternative to bridging therapy in patients at high risk of venous thromboembolism and/or bleeding.
Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, RI, USA.
Nikhil A
NA
Thakur
John K
JK
Czerwein
James N
JN
Butera
Mark A
MA
Palumbo
D000925:Anticoagulants / Q000008:administration & dosage*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D019934:International Normalized Ratio; D019637:Orthopedic Procedures; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D013923:Thromboembolism / Q000517:prevention & control*; D016306:Vena Cava Filters; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin