title: Pulmonary artery re-thrombosis following interruption of anti-thrombotic therapy for bilateral carpal tunnel release surgery: an update of current protocols.
abstract: In the perioperative period, patients who are under anti-thrombotic therapy should be managed with care, although there is no clear consensus on this matter. For hand surgery, several authors have advocated no interruption of the anti-thrombotic therapy, but the choice differs between institutes according to protocols and surgeons' preference. We report a case of massive pulmonary embolism after stopping warfarin for carpal tunnel release in a patient with a previous history of pulmonary embolism. Although the patient recovered after thrombolytic therapy and intensive care unit (ICU) care, this case has struck the authors as a valuable lesson. In managing anti-thrombotic therapy, we should weigh the risks and benefits of the patients carefully before making a decision.
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, 17 Haengdang-Dong, Seongdong-Gu, Seoul 133-792, Republic of Korea.
authors.forename: Jong Do
authors.initials: JD
authors.lastname: Kim
authors.forename: Jeong Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Aaron W T
authors.initials: AW
authors.lastname: Gan
authors.forename: Seungki
authors.initials: S
authors.lastname: Youn
authors.forename: Youn Hwan
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy; D011300:Preoperative Care / Q000379:methods; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D020127:Recovery of Function; D012008:Recurrence; D019233:Retreatment; D015912:Thrombolytic Therapy / Q000379:methods*; D014859:Warfarin / Q000627:therapeutic use; D028761:Withholding Treatment; D014945:Wound Healing / Q000502:physiology
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin