Periprocedural reversal and bridging of anticoagulant treatment

M. Levi, E. Eerenberg, P.W. Kamphuisen

Research output: Contribution to journalBook/Film/Article reviewProfessional

14 Citations (Scopus)

Abstract

Anticoagulants are effective agents in reducing the risk of thromboembolism but the most important adverse effect of these agents is the occurrence of bleeding. Bleeding complications may occur spontaneously but the risk of bleeding is particularly increased in case of trauma or around invasive procedures. If patients being treated with anticoagulants need to undergo an invasive intervention, physicians need to consider whether to interrupt the use of this medication or to allow its use to be continued. Suspending the use of anticoagulants increases the risk of thrombosis, whereas continued use may cause bleeding complications. To shorten the period in which anticoagulant treatment is interrupted, bridging strategies have been advocated. No evidence-based scientific research has been carried out regarding best practice for the perioperative use of anticoagulants. The periprocedural anticoagulation policy in patients should be individualised based on the risk of a thromboembolic complication (which can be estimated with available scoring systems) offset against the bleeding risk associated with the intervention. © Van Zuiden Communications B.V. All rights reserved.
Original languageEnglish
Pages (from-to)268-273
Number of pages6
JournalNetherlands Journal of Medicine
Volume69
Issue number6
Publication statusPublished - 1-Jun-2011

Keywords

  • Anticoagulants
  • Aspirin
  • Bridging
  • Clopidogrel
  • Hemorrhage
  • Heparin
  • Prasugrel
  • Surgery
  • Vitamin K antagonists
  • acetylsalicylic acid
  • antivitamin K
  • clopidogrel
  • desmopressin
  • heparin
  • low molecular weight heparin
  • phenprocoumon
  • placebo
  • prasugrel
  • vitamin K group
  • warfarin
  • anticoagulant therapy
  • bleeding
  • clinical practice
  • evidence based medicine
  • heart atrium fibrillation
  • human
  • perioperative period
  • review
  • risk factor
  • scoring system
  • thromboembolism
  • thrombosis
  • venous thromboembolism

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