| Title | Serious adverse vascular events associated with perioperative interruption of antiplatelet and anticoagulant therapy. | | Author(s) | Alam M, Goldberg LH | | Institution | Division of Cutaneous and Aesthetic Surgery, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. murad@alam.com | | Source | Dermatol Surg 2002 Nov; 28(11):992-8; discussion 998. | | MeSH | Aged
Anticoagulants
Aspirin
Carcinoma, Basal Cell
Drug Administration Schedule
Female
Heparin, Low-Molecular-Weight
Humans
Mohs Surgery
Nose Neoplasms
Platelet Aggregation Inhibitors
Postoperative Complications
Practice Guidelines as Topic
Skin Neoplasms
Ticlopidine
Venous Thrombosis
| | Abstract | BACKGROUND: Antithrombotic medications may increase perioperative bleeding during cutaneous surgery. Whether to discontinue these medications before surgery is controversial.
OBJECTIVE: To evaluate the available evidence in order to generate preliminary guidelines regarding the perioperative use of antithrombotics.
METHODS: Presentation of two cases of adverse events after preoperative discontinuation of antithrombotics, review of current anticoagulant and antiplatelet drugs, and review of the literature concerning perioperative antithrombotics in cutaneous surgery.
RESULTS: Perioperative withholding of antithrombotics in cutaneous surgery may be associated with serious adverse vascular events. Continuing antithrombotics in these circumstances does not appear to significantly increase bleeding complications. The complexity of available antithrombotics makes case-by-case determinations regarding their use difficult.
CONCLUSION: Cutaneous surgeons should strongly consider perioperative continuation of patients' antithrombotic drugs. The final determination should be made by the surgeon after evaluation of the circumstances and, if necessary, consultation with other experts. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 12460291 |
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