Perioperative Management of Oral Anticoagulants and Antiplatelet Therapy in Hand and Wrist Surgery.
Gregory G GallantJonas L MatzonPedro K BeredjiklianMichael RivlinPublished in: The Journal of the American Academy of Orthopaedic Surgeons (2023)
There is wide variability in the management of patients on antithrombotic therapy requiring surgery of the hand and wrist. There are no specific guidelines regarding whether to temporarily cease or continue oral anticoagulants and antiplatelet agents. Discontinuation of these medications before surgery can lead to perioperative thromboembolic or ischemic events. On the other hand, continuation can lead to intraoperative or postoperative bleeding complications. This review discusses various anticoagulants and antiplatelet agents with special considerations for their management, analyzes the current literature, summarizes current recommendations, and provides direction for additional research.
Keyphrases
- atrial fibrillation
- oral anticoagulants
- minimally invasive
- coronary artery bypass
- antiplatelet therapy
- patients undergoing
- percutaneous coronary intervention
- surgical site infection
- acute coronary syndrome
- cardiac surgery
- systematic review
- risk factors
- mesenchymal stem cells
- bone marrow
- cerebral ischemia
- replacement therapy