Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26976713
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26976713
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Dtsch+Arztebl+Int
2016 ; 113
(8
): 129-35
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The Periprocedural Management of Anticoagulation and Platelet Aggregation
Inhibitors in Endoscopic Interventions
#MMPMID26976713
Lange CM
; Fichtlscherer S
; Miesbach W
; Zeuzem S
; Albert J
Dtsch Arztebl Int
2016[Feb]; 113
(8
): 129-35
PMID26976713
show ga
BACKGROUND: In Germany, more than half a million persons, most of them elderly,
are under long-term treatment with anticoagulants. The approval of new oral
anticoagulants and platelet aggregation inhibitors, as well as new data on
periprocedural bridging with heparins, have introduced marked complexity to the
management of treatment with anticoagulants and platelet aggregation inhibitors
for endoscopic interventions in visceral surgery. METHODS: This review is based
on pertinent publications retrieved by a selective literature search in PubMed,
as well as on the relevant guidelines. RESULTS: Robust data are available on the
management of vitamin K antagonists (VKA) and platelet aggregation inhibitors for
endoscopic procedures; on the other hand, the data on the periprocedural
management of non-VKA oral anticoagulants (NOAC) are still inadequate. Endoscopic
procedures that carry a low risk of bleeding can be performed under treatment
with anticoagulants or platelet aggregation inhibitors. Before any procedure with
a high risk of bleeding (? 1.5%) oral anticoagulants of any type and P2Y12
inhibitors should generally be discontinued. Patients in whom VKA are temporarily
discontinued for this reason need bridging treatment with heparin only if they
are at high risk of thromboembolic events (? 10% per year). For patients who are
anticoagulated with NOAC, timely discontinuation of the drug depending on renal
function is of key importance, and bridging is usually unnecessary. CONCLUSION:
Adequate scientific evidence supports the current recommendations and treatment
algorithms for the periprocedural management of oral anticoagulants and platelet
aggregation inhibitors in endoscopic procedures. Larger-scale studies are still
needed to provide a sound basis for the corresponding recommendations about NOAC.
free
free
free
