Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy
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Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy. / Hanken, Henning; Gröbe, Alexander; Heiland, Max; Smeets, Ralf; Kluwe, Lan; Wikner, Johannes; Koehnke, Robert; Al-Dam, Ahmed; Eichhorn, Wolfgang.
In: CLIN ORAL INVEST, Vol. 20, No. 6, 07.2016, p. 1279-82.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy
AU - Hanken, Henning
AU - Gröbe, Alexander
AU - Heiland, Max
AU - Smeets, Ralf
AU - Kluwe, Lan
AU - Wikner, Johannes
AU - Koehnke, Robert
AU - Al-Dam, Ahmed
AU - Eichhorn, Wolfgang
PY - 2016/7
Y1 - 2016/7
N2 - OBJECTIVES: The purpose of this study was to assess the risk of postoperative bleeding complications after oral procedures performed under continued mono or dual anticoagulation therapy with rivaroxaban (and aspirin).METHODS: This retrospective single-center observational study included 52 oral procedures performed under continued oral anticoagulant therapy with rivaroxaban (20 mg/day). Among them, two procedures were performed under continued dual therapy with aspirin (100 mg/day) added to the regimen. Postoperative bleeding events were compared with 285 oral procedures in patients without any anticoagulation/antiplatelet therapy.RESULTS: Postoperative bleeding complications after oral surgery occurred significantly more often in patients under continued rivaroxaban therapy (11.5 %) than in the control cases without anticoagulation/antiplatelet medication (0.7 %). All of the bleeding events were manageable: Two of them were treated with local compression, three by applying new fibrin glue with (one case) or without (two cases) secondary sutures, one occurred during a weekend and was therefore treated under inpatient conditions with suture replacement. All postoperative bleeding episodes occurred during the first postoperative week.CONCLUSIONS: According to our data, continued anticoagulation therapy with rivaroxaban significantly increases postoperative bleeding risk for oral surgical procedures, although the bleeding events were manageable.CLINICAL RELEVANCE: Oral surgeons, cardiologists, general physicians, and patients should be aware of the increased bleeding risk after oral surgical procedures. Close observation up to 1 week postoperatively is advisable to prevent excessive bleeding.
AB - OBJECTIVES: The purpose of this study was to assess the risk of postoperative bleeding complications after oral procedures performed under continued mono or dual anticoagulation therapy with rivaroxaban (and aspirin).METHODS: This retrospective single-center observational study included 52 oral procedures performed under continued oral anticoagulant therapy with rivaroxaban (20 mg/day). Among them, two procedures were performed under continued dual therapy with aspirin (100 mg/day) added to the regimen. Postoperative bleeding events were compared with 285 oral procedures in patients without any anticoagulation/antiplatelet therapy.RESULTS: Postoperative bleeding complications after oral surgery occurred significantly more often in patients under continued rivaroxaban therapy (11.5 %) than in the control cases without anticoagulation/antiplatelet medication (0.7 %). All of the bleeding events were manageable: Two of them were treated with local compression, three by applying new fibrin glue with (one case) or without (two cases) secondary sutures, one occurred during a weekend and was therefore treated under inpatient conditions with suture replacement. All postoperative bleeding episodes occurred during the first postoperative week.CONCLUSIONS: According to our data, continued anticoagulation therapy with rivaroxaban significantly increases postoperative bleeding risk for oral surgical procedures, although the bleeding events were manageable.CLINICAL RELEVANCE: Oral surgeons, cardiologists, general physicians, and patients should be aware of the increased bleeding risk after oral surgical procedures. Close observation up to 1 week postoperatively is advisable to prevent excessive bleeding.
U2 - 10.1007/s00784-015-1627-9
DO - 10.1007/s00784-015-1627-9
M3 - SCORING: Journal article
C2 - 26498769
VL - 20
SP - 1279
EP - 1282
JO - CLIN ORAL INVEST
JF - CLIN ORAL INVEST
SN - 1432-6981
IS - 6
ER -