Perioperative Management of the Direct Oral Anticoagulants: A Case-Based Review

被引:10
|
作者
Bell, Benjamin R. [1 ]
Spyropoulos, Alex C. [2 ,3 ]
Douketis, James D. [4 ]
机构
[1] Univ Toronto, Toronto, ON, Canada
[2] Northwell Hlth Syst Lenox Hill Hosp, Hofstra Northwell Sch Med, Anticoagulat Serv, 130 E,77th St, New York, NY 10075 USA
[3] Northwell Hlth Syst Lenox Hill Hosp, Hofstra Northwell Sch Med, Clin Thrombosis Serv, 130 E,77th St, New York, NY 10075 USA
[4] McMaster Univ, St Josephs Hosp, Div Hematol & Thromboembolism, Dept Med, 50 Charlton Ave East,Room F-544, Hamilton, ON L8N 4A6, Canada
关键词
Direct oral anticoagulants; Perioperative management; Algorithm; Thrombosis; ATRIAL-FIBRILLATION; WARFARIN; DABIGATRAN; INTERRUPTION; PREVENTION; REVERSAL; OUTCOMES; THERAPY; HEPARIN; IDARUCIZUMAB;
D O I
10.1016/j.hoc.2016.05.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach. A free online clinical guidance tool is available from Thrombosis Canada that includes the proposed management algorithm.
引用
收藏
页码:1073 / +
页数:14
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