Extracorporeal Shockwave Lithotripsy in Patients Treated with Antithrombotic Agents

Zanetti, G.; Kartalas-Goumas, I.; Montanari, Emanuele; Federici, Augusto B.; Trinchieri, Alberto; Rovera, F.; Pisani, E.

doi:10.1089/089277901750161656

Cited by 27 publications

(20 citation statements)

References 24 publications

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“…115 The only prospective SWL study of patients on anti-platelet agents is that of Zanetti and colleagues. 116 In this level 2b study, 23 patients were stratified to being at low-risk or at highrisk of thromboembolic events. Low-risk patients had their antiplatelet agents withheld for eight days prior to SWL, whereas high-risk patients received unfractionated heparin 5000 units thrice daily while anti-platelet agents were held.…”

Section: Anti-coagulationmentioning

confidence: 99%

“…There were no hematomas or thromboembolic events in either group. 116 Recent advances in manufacturing small-calibre ureteroscopes and introduction of Ho:YAG laser energy in lithotripsy have made it possible for patients with coagulopathies to safely undergo URS and laser lithotripsy while anticoagulated. 110,[117][118][119] However, this is associated with lower stone-free rates and increased risk of postoperative gross hematuria necessitating admission and bladder irrigation.…”

Section: Anti-coagulationmentioning

confidence: 99%

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CUA Guideline: Management of ureteral calculi

Ordon

Andonian²,

Blew³

et al. 2015

CUAJ

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The focus of this guideline is the management of ureteral stones. Specifically, the topics covered include: conservative management, medical expulsive therapy, active intervention with either shockwave lithotripsy (SWL) or ureteroscopy (URS), factors affecting SWL treatment success, optimizing success, and special considerations (e.g., pregnancy, urinary diversion). By performing extensive literature reviews for each topic evaluated, we have generated an evidence-based consensus on the management of ureteral stones. The objective of this guideline is to help standardize the treatment of ureteral stones to optimize treatment outcomes.

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Section: Anti-coagulationmentioning

confidence: 99%

Section: Anti-coagulationmentioning

confidence: 99%

CUA Guideline: Management of ureteral calculi

Ordon

Andonian²,

Blew³

et al. 2015

CUAJ

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“…7 This is Level III evidence according to the Cochrane classification. Twenty-three patients taking antiplatelet agents (acetylsalicylic acid [ASA], ticlopidine, dipyridamole) were stratified according to author-defined risk levels.…”

Section: Patients Without Drug-eluting Stents Requiring Antiplatelet mentioning

confidence: 99%

Shock wave lithotripsy in patients requiring anticoagulation or

Alsaikhan

Andonian

2011

CUAJ

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Extracorporeal shockwave lithotripsy (SWL) remains the only truly minimally invasive procedure for the treatment of upper tract nephrolithiasis. Recently, there has been a recent rise in the patients on antiplatelet agents. Therefore, the aim of the present study is to review the literature available regarding SWL in these high-risk patients requiring anti-coagulation therapy. Alternative therapies to SWL are also presented. RésuméLa lithotripsie extracorporelle par ondes de choc (LECOC) demeure la seule intervention qui soit réellement minimalement invasive pour le traitement de la néphrolithiase dans les voies urinaires supéri-eures. Récemment, on a noté une hausse du nombre de patients traités par antiplaquettaires. Par conséquent, le but de la présente étude est d'examiner les articles publiés sur la LECOC chez ces patients à risque élevé ayant besoin d'un traitement anticoagulant. On présente également des traitements de rechange à la LECOC.

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“…Of these: five RCTs, 50-54 two observational cohorts, 38,55 nine case series, 56-64 and 33 case reports across 17 publications [65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] investigated clopidogrel and ticlopidine therapy. Only two case series 82,83 and two case reports in a single publication 84 were identified for patients who had not undergone PCI. Table 1 shows the results for each criterion of the assessment of the quality for each included RCT.…”

Section: Quantity Of Research Availablementioning

confidence: 99%

“…[82][83][84] One reported a case series of 23 patients who were to undergo lithotripsy and who were taking antiplatelet therapy, owing to previous MI, coronary artery bypass graft (CABG), TIA, chronic atrial fibrillation or PAD. 83 Antiplatelet therapy was discontinued 8 days before lithotripsy and haemorrhagic and thromboembolic events were reported. Of these 23 patients, three received ticlopidine (the remaining patients received either aspirin or dipyridamole), none of whom showed any thromboembolic complications.…”

Section: Pad Stroke MI and Discontinuation For Non-pci Surgerymentioning

confidence: 99%

The effect of different treatment durations of clopidogrel in patients with non-ST-segment elevation acute coronary syndromes: a systematic review and value of information analysis

Rogowski

Burch²,

Palmer³

et al. 2009

Health Technol Assess

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Extracorporeal Shockwave Lithotripsy in Patients Treated with Antithrombotic Agents

Abstract: Our schedules for the suspension or substitution of antithrombotic therapy, although tested in a small number of patients, allowed us to perform SWL without hemorrhagic or thromboembolic complications.

Cited by 27 publications

References 24 publications

CUA Guideline: Management of ureteral calculi

CUA Guideline: Management of ureteral calculi

Shock wave lithotripsy in patients requiring anticoagulation or

The effect of different treatment durations of clopidogrel in patients with non-ST-segment elevation acute coronary syndromes: a systematic review and value of information analysis

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