Bleeding time determination is not advised as a general preoperative hemostasis screening test, but it might be useful in some patient groups. Patients referred for liver biopsy frequently have coagulation disturbances and are at risk of hemorrhage. In this prospective study 219 liver biopsies were carried out regardless of a prolonged bleeding time, but with minimum requirements for hemoglobin concentration, platelet count, and tests of the internal and external coagulation pathways. The bleeding time was prolonged in the case of 48 (22%) of the biopsies. Significant bleeding as defined by a hemoglobin decrease of > or =2.0 g/dl occurred in nine patients. Three of these patients were bone marrow transplanted. Patients with a prolonged bleeding time carried a five times higher risk of bleeding (odds ratio = 5.0; confidence interval = 1.1-21.8; p = 0.019). We conclude that the bleeding time may give additional information on the risk of bleeding in some patient groups undergoing liver biopsy.
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Swiss Med Wkly
January 2025
Department of Cardiology and Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
Background: Coronary artery ectasias and aneurysms (CAE/CAAs) are among the less common forms of coronary artery disease, with undefined long-term outcomes and treatment strategies.
Aims: To assess the clinical characteristics, angiographic patterns, and long-term outcomes in patients with CAE, CAA, or both.
Methods: This 15-year (2006-2021) retrospective single-centre registry included 281 patients diagnosed with CAE/CAA via invasive coronary angiography.
Front Digit Health
January 2025
Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy.
Introduction: Limb massive hemorrhage is the first cause of potentially preventable death in trauma. Its prompt and proper management is crucial to increase the survival rate. To handle a massive hemorrhage, it is important to train people without medical background, who might be the first responders in an emergency.
View Article and Find Full Text PDFInt J Stroke
January 2025
Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Background: Hematoma expansion after intracranial hemorrhage (ICH) in anticoagulated patients signifi-cantly influences clinical outcomes and mortality, emphasizing the need for effective reversal agents. Andexanet alfa is a specific reversal agent for factor Xa associated major bleeding.
Aims: The ASTRO-DE study collected real-world evidence on the effect of andexanet alfa on mitigat-ing hematoma expansion and altering prognosis in rivaroxaban- or apixaban-treated patients with ICH.
J Cardiothorac Surg
January 2025
Division of Clinical Medicine, University of Sheffield, Sheffield, UK.
Objective: Patients on direct-acting oral anticoagulants (DOACs) are at high risk of perioperative bleeding complications. Intraoperative hemoadsorption is a novel strategy to reduce perioperative bleeding in patients on DOACs undergoing non-deferable cardiac surgery. The international STAR-registry reports real-world clinical outcomes associated with this application.
View Article and Find Full Text PDFOrthopadie (Heidelb)
January 2025
ECOM, Praxis für Orthopädie, Sportmedizin und Unfallchirurgie, München, Deutschland.
Background: Hip and knee arthroplasty remain risk procedures for bleeding complications. The prevalence of preoperative anaemia prior to elective joint replacement is high. There are no standardized guidelines in Germany for the diagnosis and treatment of perioperative anaemia in elective hip and knee arthroplasty.
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