Überbrückende Antikoagulation bei Patienten unter Vitamin-K-Antagonisten: Eine Bestandsaufnahme
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Überbrückende Antikoagulation bei Patienten unter Vitamin-K-Antagonisten: Eine Bestandsaufnahme. / Schellong, S M; Riess, H; Spannagl, M; Omran, H; Schwarzbach, M; Langer, F; Gogarten, W; Bramlage, P; Bauersachs, R M.
in: ANAESTHESIST, Jahrgang 67, Nr. 8, 08.2018, S. 599-606.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Überbrückende Antikoagulation bei Patienten unter Vitamin-K-Antagonisten: Eine Bestandsaufnahme
AU - Schellong, S M
AU - Riess, H
AU - Spannagl, M
AU - Omran, H
AU - Schwarzbach, M
AU - Langer, F
AU - Gogarten, W
AU - Bramlage, P
AU - Bauersachs, R M
PY - 2018/8
Y1 - 2018/8
N2 - Approximately 30% of patients receiving oral anticoagulation using vitamin K antagonists (VKA) require surgery within 2 years. In this context, a clinical decision on the need and the mode of a peri-interventional bridging with heparin is needed. While a few years ago, bridging was almost considered a standard of care, recent study results triggered a discussion on which patients will need bridging at all. Revisiting the currently available recommendations and study results the conclusion can be drawn that the indications for bridging with heparin must nowadays be taken more narrowly and considering the individual patient risk of bleeding and thromboembolism. Bridging with heparin is only needed in patients with a very high risk of thromboembolism. This overview aims to give guidance for a risk-adapted peri-interventional approach to management of patients with a need for long-term anticoagulation using VKA.
AB - Approximately 30% of patients receiving oral anticoagulation using vitamin K antagonists (VKA) require surgery within 2 years. In this context, a clinical decision on the need and the mode of a peri-interventional bridging with heparin is needed. While a few years ago, bridging was almost considered a standard of care, recent study results triggered a discussion on which patients will need bridging at all. Revisiting the currently available recommendations and study results the conclusion can be drawn that the indications for bridging with heparin must nowadays be taken more narrowly and considering the individual patient risk of bleeding and thromboembolism. Bridging with heparin is only needed in patients with a very high risk of thromboembolism. This overview aims to give guidance for a risk-adapted peri-interventional approach to management of patients with a need for long-term anticoagulation using VKA.
KW - English Abstract
KW - Journal Article
KW - Review
U2 - 10.1007/s00101-018-0463-0
DO - 10.1007/s00101-018-0463-0
M3 - SCORING: Review
C2 - 29926118
VL - 67
SP - 599
EP - 606
JO - ANAESTHESIST
JF - ANAESTHESIST
SN - 0003-2417
IS - 8
ER -