Antithrombotic Strategies in Vascular Surgery: Evidence and Practice

Assadian, Afshin; Senekowitsch, C.; Assadian, Ojan; Eidher, U.; Hagmüller, G. W.; Knöbl, Paul

doi:10.1016/j.ejvs.2005.01.021

Cited by 17 publications

(11 citation statements)

References 22 publications

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“…Surveys on heparin use in the daily practice of vascular surgeons and interventional radiologists have been performed throughout Europe, 14,15 the UK 16e18 and the United States (US). 9,19 They showed wide variation in the prophylactic use of heparin (and protamine for heparin reversal) perioperatively in reconstructive arterial surgery, both for open and endovascular procedures.…”

mentioning

confidence: 99%

Prophylactic Perioperative Anti-Thrombotics in Open and Endovascular Abdominal Aortic Aneurysm (AAA) Surgery: A Systematic Review

Wiersema

Jongkind

Bruijninckx³

et al. 2012

European Journal of Vascular and Endovascular Surgery

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mentioning

confidence: 99%

Prophylactic Perioperative Anti-Thrombotics in Open and Endovascular Abdominal Aortic Aneurysm (AAA) Surgery: A Systematic Review

Wiersema

Jongkind

Bruijninckx³

et al. 2012

European Journal of Vascular and Endovascular Surgery

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“…In the review of 225 symptomatic cervicocranial FMD patients, both medical and surgical treatments resulted in a favorable outcome. Some suggested surgical procedures or angioplasty are the favored treatment in stenotic FMD lesions if associated with progressing ischemia irrelevant to the cause of stenosis (table 3) [13,15,27,28,29,30,31,32,33,34,35]. In FMD patients with carotid kinking or coiling, surgical correction provides better stroke prevention [36].…”

Section: Discussionmentioning

confidence: 99%

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Liu

Wu²,

Chin³

et al. 2012

Eur Neurol

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Introduction: Clinical research of cervicocranial fibromuscular dysplasia (FMD) is rare in Asian populations. Our study reviewed Taiwanese ischemic stroke patients with cervicocranial FMD and compared them with previous reports. Methods: Between 2000 and 2011, we collected 19 consecutive cervicocranial FMD patients who received demographic registration, a blood test for excluding vasculitis, and comprehensive angiography. Cerebral ultrasound, vascular images and clinical outcomes (Barthel index, modified Rankin scale, recurrent stroke, or death) were monitored during follow-up. Results: Of the 19 patients, 16 (84%) had carotid FMD, while 7 (37%) had vertebral FMD. Only 2 investigated patients (13%) had renal FMD and 1 (5%) had cerebral aneurysm. 14 (74%) presented acute arterial dissection. All patients received medical treatment and had neither recurrent stroke nor dissection during follow-up. In the literature review of 225 FMD patients, 3.6% had recurrent stroke during follow-up, and some reported surgical procedure or angioplasty could give a good clinical outcome in progressing ischemia irrelevant to the cause of stenosis. Conclusion: In Taiwanese cervicocranial FMD patients, arterial dissection was one of the most common clinical presentations. Most of our patients had isolated involvement of the cervicocranial artery and carried a favorable outcome under medical treatment.

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“…30 -32 Although vascular patients are at high risk of cardiovascular events, bleeding concerns are a major disincentive for the investigation of perioperative intensive antiplatelet regimes, and perhaps underlie the paucity of such data. Most published reports are observational, 33,34 although randomized-controlled trials of dual antiplatelet therapy have been performed in patients undergoing carotid endarterectomy 35 and peripheral angioplasty, 36 and report no major increase in bleeding complications. However, there have been no randomized-controlled trials of dual antiplatelet therapy in surgery for critical limb ischemia, where the potential for both perioperative bleeding and cardiac complications is greater.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of Dual Antiplatelet Therapy in Patients Undergoing Surgery for Critical Limb Ischemia

Burdess¹,

Nimmo²,

Garden³

2010

Journal of Vascular Surgery

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et al. Br J Surg 2010;97:650-6.Conclusion: There are no differences between sclerotherapy results in patients treated for truncal varices with foam sclerotherapy regardless of whether compression therapy after the procedure is used for 1 or 5 days.Summary: There are no data on the optimal bandaging regimen after foam sclerotherapy for truncal varices. In Great Britain, 80% of the members of the Vascular Society of Great Britain and Ireland responding to a questionnaire, and who treated patients with sclerotherapy, indicated they used compression bandages, and 90% subsequently used compression stockings after compression bandaging. Duration of treatment ranged from 1 to 7 days for initial bandages, with compression stockings used for 7 to 14 days, with some surgeons recommending compression stockings for up to 3 months. The authors sought to determine whether duration of bandaging could be reduced after foam sclerotherapy for truncal varices.Patients with primary uncomplicated varicose veins were randomized after foam sclerotherapy treatment to wearing compression bandaging for 24 hours or 5 days. In each case after compression bandages were removed, thromboembolism deterrent (TED) stockings then used for a total of 14 days of compression after foam sclerotherapy. The primary end point of the study was the 6-week Aberdeen Varicose Vein Severity Score (AVVSS) and Buford pain score. The study randomized 124 legs, of which 61 were randomized to 24 hours of compression bandaging and 63 to 5 days of compression bandaging. Venous occlusion rates at 6 weeks were 90% and 89%, respectfully (P ϭ .842). There were no differences in phlebitis after 2 weeks (P ϭ .445), skin discoloration after 6 weeks (46% vs 40%; P ϭ .546). There were no differences between groups in the AVVSS from baseline to 2 weeks (-0.29 vs -0.80; P ϭ .717) or to 6 weeks (-5.89 vs -5.14; 95% confidence interval [CI] for the difference, -3.29 to 1.8; P ϭ .563). There were also no differences between groups in changes in the Buford pain score from baseline to 2 weeks (-9.04 vs -2.80, P ϭ .248) or to 6 weeks (-17.32 vs -8.46; 95% CI for the difference, -19.06 to 1.33; P ϭ .088). Finally, the two groups also did not demonstrate any differences in changes in the Short Form-36 score from baseline to 6 weeks (2.02 vs. 1.74; P ϭ .903).Comment: Foam sclerotherapy is replacing liquid sclerotherapy as the preferred method of sclerotherapy for patients with truncal varicosities. Compression after treatment is essential to optimal results. However, as the authors point out with respect to foam sclerotherapy, the optimal duration of compression after treatment has not been adequately studied. This study is good news for patients. Compression bandages are not comfortable, and the results indicate that 24 hours of compressive bandaging, followed by a TED stocking for a total of 2 weeks, is just as efficacious as 5 days of compressive bandaging, followed by a TED stocking for a total of 2 weeks. The study provides practical guidance for post-therapy bandaging of patients...

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Antithrombotic Strategies in Vascular Surgery: Evidence and Practice

Cited by 17 publications

References 22 publications

Prophylactic Perioperative Anti-Thrombotics in Open and Endovascular Abdominal Aortic Aneurysm (AAA) Surgery: A Systematic Review

Prophylactic Perioperative Anti-Thrombotics in Open and Endovascular Abdominal Aortic Aneurysm (AAA) Surgery: A Systematic Review

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Randomized Controlled Trial of Dual Antiplatelet Therapy in Patients Undergoing Surgery for Critical Limb Ischemia

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