Nontraumatic Spinal Epidural Hematoma Associated with Clopidogrel

Karabatsou, Konstantina; Sinha, Amitasha; Das, Kuntal; Ng, Rainov

doi:10.1055/s-2006-933536

Cited by 15 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…36 The potency of these medications is demonstrated by recent reports of spontaneous spinal hematomas during clopidogrel therapy. [226][227][228] Ticagrelor Ticagrelor (Brilinta) represents a new class of nonthienopyridine platelet inhibitors designed to address the limitations of current oral platelet drugs. Ticagrelor completely but reversibly inhibits ADP-induced platelet activation, unlike the thienopyridines (eg, clopidogrel, prasugrel).…”

Section: Thienopyridinesmentioning

confidence: 99%

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Horlocker

Vandermeuelen

Kopp

et al. 2018

Regional Anesthesia and Pain Medicine

746

106

View full text Add to dashboard Cite

Section: Thienopyridinesmentioning

confidence: 99%

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Horlocker

Vandermeuelen

Kopp

et al. 2018

Regional Anesthesia and Pain Medicine

746

106

View full text Add to dashboard Cite

“…[18][19][20][21] Several case reviews report that this risk is much more than just theoretical for patients on aspirin, clopidogrel, or a combination of the two. [22][23][24][25][26][27] For these reasons, spinal surgeons have a vested interest in seeking out any variables that they may be able to adjust to mitigate these risks while still doing what is ultimately best for the overall health of the patient.…”

Section: Chronic Antiplatelet Use Associated With Increased Blood Losmentioning

confidence: 99%

Chronic Antiplatelet Use Associated With Increased Blood Loss in Lumbar Spinal Surgery Despite Adherence to Protocols

McCunniff¹,

Young²,

Ahmadinia³

et al. 2016

Orthopedics

View full text Add to dashboard Cite

There are conflicting reports regarding postoperative bleeding risks associated with discontinuation of antiplatelet therapy at least 7 days preoperatively. Most of the studies in the spine literature are based on surveys or anecdotal evidence. The majority of surgeons discontinue therapy 7 days preoperatively, but this varies widely from 5 to 21 days. The purpose of this retrospective study was to assess whether chronic antiplatelet use is associated with increased intraoperative blood loss, need for transfusion, and perioperative complications. Of 454 patients who underwent elective lumbar spinal surgery, 85 were on antiplatelet therapy and 369 were not. All patients stopped antiplatelet therapy at least 7 days preoperatively with approval from their cardiologist or primary care provider. Multiple regression analysis was performed and corrected for age, sex, antiplatelet therapy, number of levels decompressed/fused/instrumented, preoperative hematocrit, and postoperative hematocrit. Results showed that preoperative antiplatelet therapy, despite at least 7 days of discontinuation, is a statistically significant predictor (P=.04) of increased intraoperative blood loss. Blood transfusion was not associated with antiplatelet use but was associated with the number of levels fused, age, and low preoperative hematocrit (all P<.01). There were no recorded complications in either group. The authors conclude that antiplatelet therapy is associated with an increased risk of intraoperative blood loss in spine patients despite discontinuation at least 7 days preoperatively, but the clinical significance of this is unclear given the lack of association with blood transfusions and perioperative complications. [Orthopedics. 2016; 39(4):e695-e700.].

show abstract

“…11,12 Interventionist techniques: vertebroplasty, 13 arterial embolization, 14 epidural anesthesia, 15 intramuscular injections, 16 acupuncture. 17 Drugs: platelet antiaggregants, 18 acenocumarol, 19 tumor necrosis factor. 20 Physical therapy: manipulation.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic spinal cord injury: an observational study

et al. 2011

View full text Add to dashboard Cite

Study design: Retrospective descriptive observational study. Objective: The primary objective of this study was to quantify the incidence of iatrogenic spinal cord injury (SCI) at our SCI unit (SCIU). The secondary objective was to discover the surgical and medical procedures that cause iatrogenic SCI and to estimate the incidence with each procedure. Subjects: Patients admitted to or seen at outpatient services of the SCIU at a university hospital. Methods: Histories were compiled from 1 July 2005 to 30 June 2009. We included patients with SCI caused by any medical or surgical procedure. We collected age, sex, diagnosis leading to medical intervention, predominant clinical manifestations, medical-surgical procedure and level and grade of injury upon admission and discharge. Results: Out of 250 patients admitted to the SCIU, 32 (14.7%) patients presented iatrogenic SCI. Average age was 56.2 (s.d. 17.3), ranging from 0 to 82 years old. The most frequent clinical manifestation was pain. The most common diagnosis was channel stenosis. Lumbar level grade C of American Spine Injury Association (ASIA) was the most frequently observed. Conclusion: The rise in the population's life expectancy entails an increase in elderly patients with vascular risk factors, who underwent invasive interventions leading to spinal cord iatrogenia.

show abstract

Nontraumatic Spinal Epidural Hematoma Associated with Clopidogrel

Cited by 15 publications

References 9 publications

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

Chronic Antiplatelet Use Associated With Increased Blood Loss in Lumbar Spinal Surgery Despite Adherence to Protocols

Iatrogenic spinal cord injury: an observational study

Contact Info

Product

Resources

About