Preparation of patients on anticoagulant treatment for invasive surgery

Česká verzia

Authors: M. Brejcha ¹; J. Gumulec ²; M. Penka ³; D. Klodová ¹; M. Wróbel ¹; E. Bogoczová ¹
Authors place of work: Hematologické oddělení, Onkologické centrum J. G. Mendela Nový Jičín, přednosta prim. MUDr. Martin Brejcha ¹; Hemato-onkologické a transfuzní centrum FN Ostrava, přednosta prim. MUDr. Jaromír Gumulec ²; Oddělení klinické hematologie FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Miroslav Penka, CSc. ³
Published in the journal: Vnitř Lék 2009; 55(3): 272-275
Category: 15th Parizek's Days

Summary

The management of warfarin therapy in patients undergoing surgery or other invasive procedures involves a balance between the risk of hemorrhage, and the risk of thrombosis. Risk of hemorrhage and the trombosis depends on the type of procedure and on pre‑existing conditions. Procedures with low risk of hemorrhage (dental, dermatologic or ophtalmologic procedures, endoscopy) can be provided with continuing anticoagulant therapy. Surgery with high hemorrhagic risk need stop warfarin and start bridging anticoagulant therapy, such as unfractionated heparin or low molecular weight heparin, prior and after surgery. In patients requiring emergency surgery, vitamin K, prothrombin complex concentrate or fresh frozen plasma can be used to improve coagulation.

Key words:
anticoagulant therapy – bridging therapy

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