Perioperative and Periprocedural Management of Antithrombotic Therapy: Consensus Document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU

Vivas, David; Roldán, Inmaculada; Ferrandis, Raquel; Marı́n, Francisco; Roldán, Vanessa; Tello‐Montoliu, Antonio; Ruiz-Nodar, Juan M.; Gómez‐Doblas, Juan José; Martín, A.; Llau, Juan V.; Ramos-Gallo, M.J.; Muñoz, Rafael; Arcelus, Juan I.; Leyva, Francisco Sánchez; Alberca, Fernando; Oliva, Raquel; Gómez, Ana María; Montero, Carmen; Arikán, Fuat; Ley, L.; Santos-Bueso, E.; Figuero, Elena; Bujaldón, Antonio; Urbano, José; Otero, Rafael; Hermida, Juan Francisco; Egocheaga, Isabel; Llisterri, J.L.; Lobos, José María; Serrano, Ainhoa; Madridano, Olga; Ferreiro, José Luis; Cassinello, Concepción; Gómez-Luque, A.; Hidalgo, F.; Sierra, P.; Marco, Pascual; Mateo, José; Palomo, Vicente; Guerrero, Adrián; Anguita, Manuel; Íñiguez, Andrés

doi:10.1016/j.rec.2018.01.029

Cited by 43 publications

(40 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…116,117 To this end, a number of national multidisciplinary expert consensus documents have been published in an effort to standardize perioperative management of antithrombotic therapy based on balancing the predicted patient-specific ischemic risk with the anticipated procedure-specific bleeding risk. 118–120…”

Section: Proposed Hbr Definitionmentioning

confidence: 99%

Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention

et al. 2019

View full text Add to dashboard Cite

show abstract

Section: Proposed Hbr Definitionmentioning

confidence: 99%

Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Given the risks of general anesthesia in these patients, there is a growing interest in the use of platelet function testing, as evidenced by recent clinical guidelines suggesting that physicians should consider using these tests in selected patients. [14] The value of determining preoperative platelet function is to optimize the timing and safety of early surgery under spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a strategy to shorten the time to surgery in patients on antiplatelet therapy with a proximal femur fracture (AFFEcT Study)

et al. 2019

View full text Add to dashboard Cite

Introduction: Patients with femur fracture benefit from early surgery. Recent reports suggest that regional anesthesia may be superior to general anesthesia in these patients. Early surgery under spinal anesthesia could be performed safely by determining platelet function in patients receiving antiplatelet agents. Methods: Multicenter, randomized, open-label, parallel clinical trial expected to include 156 patients ≥ 18 years of age under chronic treatment with antiplatelet agents who develop a proximal femur fracture. Exclusion criteria: presence of multiple or pathological fractures, current treatment with vitamin K antagonists or new oral anticoagulants, and congenital or acquired coagulopathy. Patients will be randomized to either a guided early surgery strategy in which preoperative platelet function will be assessed at emergency department admission or a conventional strategy in which surgery under neuraxial anesthesia will be scheduled according to the margin of safety time established for the specific antiplatelet agent. The primary endpoint is time (hours) from admission to surgery. Secondary endpoints include: platelet function; postoperative bleeding; medical-surgical complications; perioperative and 1-year mortality; quality of life; length of hospital stay; cost-effectiveness; and cost-utility. Follow-up assessments will be performed during hospital admission and at 1, 6, and 12 months after surgery. Potential impact of the study: The determination of platelet function at admission to the emergency department in patients with femoral fracture receiving antiplatelet therapy may permit earlier surgery under spinal anesthesia, thus shortening the hospital stay and reducing the risk of complications. These advantages associated with early surgery could positively impact patient well-being and also reduce treatment-related healthcare costs. Ethics and dissemination: The study has been approved by the ethics committees at all participating centers. Their results will be disseminated in congresses and published in peer reviewed journals.

show abstract

“…If the thrombotic risk remains high, the decision to stop dual antiplatelet therapy will depend on the bleeding risk associated with the procedure. If the bleeding risk is low, they do not suggest stopping dual antiplatelet therapy but cases of moderate-to-severe risk of bleeding are more controversial and they advocate evaluating patients on a case-by-case basis within a multi-disciplinary team 25…”

Section: Discussionmentioning

confidence: 99%

Massive Hyphaema Following Laser Iridotomy in a Patient on Dual Antiplatelet Therapy (Aspirin plus Ticagrelor): Case report and literature review

Galvis

Tello

Carreño

et al. 2019

Sultan Qaboos Univ Med J

View full text Add to dashboard Cite

Massive hyphaema presentation after a laser iridotomy is very rare. We report a 63-year-old man with ischaemic heart disease on dual antiplatelet therapy (aspirin plus ticagrelor) who was diagnosed as a primary angle-closure suspect and was to undergo a neodymium-doped yttrium aluminium garnet laser iridotomy at Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia in 2016. While performing the iridotomy in the left eye, active bleeding occurred that finally filled approximately 75% of the anterior chamber. Intraocular pressure (IOP) increased to 62 mmHg. Mannitol and a topical dorzolamide/timolol were used to control the increase in IOP. The hyphaema slowly resolved over the following week without sequelae. This case revealed that massive hyphaema can complicate laser iridotomy in patients on dual antiplatelet therapy, although this is rare. Therefore, if patients are taking aspirin and ticagrelor, it would be advisable to stop the second medication if possible. In addition, sequential application of photocoagulation and photodisruption lasers might diminish the risk of significant bleeding.Keywords: Iridectomy; Nd-YAG Laser; Hyphema; Platelet Aggregation Inhibitors; Angle-Closure Glaucoma; Ocular Hypertension; Case Report; Columbia.

show abstract

Perioperative and Periprocedural Management of Antithrombotic Therapy: Consensus Document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU

Cited by 43 publications

References 51 publications

Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention

Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention

Evaluation of a strategy to shorten the time to surgery in patients on antiplatelet therapy with a proximal femur fracture (AFFEcT Study)

Massive Hyphaema Following Laser Iridotomy in a Patient on Dual Antiplatelet Therapy (Aspirin plus Ticagrelor): Case report and literature review

Contact Info

Product

Resources

About