Perioperative management of antiphospholipid antibody-positive patients.
Perioperative management of antiphospholipid antibody (aPL)-positive patients is challenging because there are limited data on which to base recommendations. This population of patients is at high risk of thrombosis at the time of surgery; it is essential that medical and surgical teams devise a plan to minimize the patient's risk of thrombosis without increasing bleeding risk. During the perioperative period, pharmacological methods should be combined with physical methods, patients should be closely observed for thrombosis, and any deviation from the normal course should be considered a potential aPL-related event. Periods without anticoagulation should be kept to an absolute minimum for aPL-positive patients with a history of thrombosis and physicians should keep in mind that thrombosis can occur despite optimum prophylaxis.
Department of Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Box 130, New York, NY, 10065, USA, kph2001@nyp.org.
Katherine H
KH
Saunders
Doruk
D
Erkan
Michael D
MD
Lockshin
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications*; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D018570:Risk Assessment / Q000379:methods; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants