The Perioperative Management of Treatment With Anticoagulants and Platelet Aggregation Inhibitors

Abstract

SUMMARYBackground: When giving anticoagulants and inhibitors of platelet aggregation either prophylactically or therapeutically, physicians face the challenge of protecting patients from thromboembolic events without inducing harmful bleeding. Especially in the perioperative period, the use of these drugs requires a carefully balanced evaluation of their risks and benefits. Moreover, the choice of drug is difficult, because many different substances have been approved for clinical use. Method: We selectively searched for relevant publications that appeared from

MRT der Prostata: Empfehlungen zur Vorbereitung und Durchführung

“…[47]. In patients with implanted coronary stents, a prostate biopsy -as an elective intervention -should only take place after dual thrombocyte aggregation inhibition (ASS + ADP antagonist (clopidogrel)) has ended and monotherapy with ASS has begun [48].…”

“…It is recommended to discontinue anticoagulation therapy if possible. A subtherapeutic INR is achieved between four and seven days after discontinuation [48]. In principle, a biopsy of the prostate can however also be performed while taking a vitamin K antagonist.…”

Perioperative Beurteilung und Behandlung kardiovaskulärer Risikopatienten für nichtherzchirurgische Eingriffe

“…Besonderes Augenmerk ist auf die Einhaltung der hämostaseologischen Rahmenbedingungen zu richten. Treten schwere Blutungen auf, wird, v. a. bei Faktor-Xa-Hemmstoffen, die Gabe von (aktiviertem) Prothrombinkomplex [7] und rekombinantem Faktor VIIa empfohlen. Dabigatran kann durch eine Hämodialy-se eliminiert werden [1].…”

Anticoagulation in Atrial Fibrillation

“…Schlitt and colleagues provide a comprehensive, practice-oriented discussion of the matter in this issue of Deutsches Ärzteblatt International (9).…”