Perioperative anticoagulant management.

Full Abstract

The oral anticoagulant warfarin is a common medication that requires special consideration in the perioperative period. Although some procedures do not require warfarin interruption, the majority will necessitate its temporary cessation due to the risk of bleeding. Determining whether patients will benefit from the temporary use of a heparin product while warfarin is discontinued perioperatively (so-called "bridging" therapy) needs to take into consideration the risk of bleeding balanced with the risk of thromboembolism. Perioperative care also requires minimizing the risk of venous thromboembolism (VTE). Understanding the patient-specific and procedure-specific risks for VTE is paramount to employ optimal risk reduction strategies. This article uses a case-based approach to present the topics of perioperative warfarin management and postoperative VTE prevention.

Author information

Author/s: Grant, Paul J (PJ); Brotman, Daniel J (DJ); Jaffer, Amir K (AK);

Affiliation: Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, 3119 Taubman Center, Ann Arbor, MI 48109-5376, USA.

Journal and publication information

Publication Type: Journal Article

Journal: The Medical clinics of North America (Med Clin North Am), published in United States. (Language: eng)

Reference: 2009-Sep; vol 93 (issue 5) : pp 1105-21

Dates: Created 2009/08/11; Completed 2009/08/28;

PMID: 19665623, status: MEDLINE (last retrieval date: 8/28/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Humans
Male
Middle Aged
Perioperative Care - methods
Polysaccharides - administration & dosage; adverse effects
Risk Factors
Vena Cava Filters
Venous Thromboembolism - prevention & control
Warfarin - administration & dosage; adverse effects

Associated Chemicals: Anticoagulants (0) ; Heparin, Low-Molecular-Weight (0) ; Polysaccharides (0) ; fondaparinux (0) ; Aspirin (50-78-2) ; Warfarin (81-81-2)

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