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Laparoscopic surgery for left ovarian hemorrhage in a patient with an implantable left ventricular assist device on antithrombotic therapy and a history of right salpingo-oophorectomy open surgery for right ovarian bleeding: A case report.
Case Rep Womens Health
December 2024
Osaka University Graduate School of Medicine, Department of Obstetrics and Gynecology, 2-2, Yamada-oka, Suita City, 565-0871 Osaka, Japan.
Ovarian hemorrhage during antithrombotic therapy is sometimes difficult to manage. A 38-year-old woman, diagnosed with Marfan syndrome and implanted with a left ventricular assist device (LVAD) and taking aspirin and warfarin potassium, had a history of right adnexal oophorectomy via open surgery for a right ovarian hemorrhage at the age of 35 years. Thereafer, she had been treated with dienogest to suppress ovulation as much as possible.
View Article and Find Full Text PDF[Current Management of Patients with Proximal Femur Fractures Receiving Antiplatelet and Anticoagulant Therapy].
Acta Chir Orthop Traumatol Cech
November 2024
II. ortopedicko-traumatologická klinika Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava.
Article Synopsis
- * The review emphasizes that patients on antiplatelet therapy (like ASA and clopidogrel) don't need to stop their medication before surgery, while those on warfarin should receive vitamin K for reversal to facilitate timely surgery.
- * Direct oral anticoagulants should be paused 24-48 hours pre-surgery, with possible use of antidotes in critical cases, and neuraxial anesthesia can be safely used under certain conditions regarding anticoagulant status.
Is the use of direct oral anticoagulants after non-cardiac thoracic surgery safe for patients?
Surg Today
January 2025
Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan.
Article Synopsis
- The study aimed to compare the safety and efficacy of direct oral anticoagulants (DOACs) and warfarin in patients after noncardiac thoracic surgery from 2008 to 2021.
- It included 434 patients, revealing low rates of thromboembolic events (0.4% for DOACs vs. 1.6% for warfarin) and similar bleeding occurrences (1.6% for DOACs and 2.1% for warfarin).
- Although outcomes were similar, the research highlights that major bleeding can happen soon after starting DOACs post-surgery, emphasizing careful monitoring when resuming these medications.
Direct Oral Anticoagulants in Older and Frail Patients with Atrial Fibrillation: A Decade of Experience.
Drugs Aging
September 2024
Department of Geriatric Medicine, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
Introduction: Both the prevalence of atrial fibrillation (AF) and its subsequent use of direct oral anticoagulants (DOACs) are rapidly increasing in patients of older age. In the absence of contra-indications, guidelines advocate anticoagulation based on the CHA2DS2-VASc score for all AF patients aged 75 and above. However, some practitioners are hesitant to prescribe anticoagulants to older and frail patients due to perceived elevated bleeding risks.
View Article and Find Full Text PDFTiming of Anticoagulation Resumption and Risk of Ischemic and Hemorrhagic Complications in Patients With ICH and Mechanical Heart Valves.
Neurology
August 2024
From the Department of Neurology (A.S., B.A., W.D.F.), Mayo Clinic, Jacksonville, FL; Departments of Neurology (A.A.R., E.F.M.W., S.A.B.) and Biostatistics (J.M.), Mayo Clinic, Rochester, MN.
Background And Objectives: In patients with mechanical heart valves and recent intracranial hemorrhage (ICH), clinicians need to balance the risk of thromboembolism during the period off anticoagulation and the risk of hematoma expansion on anticoagulation. The optimal timing of anticoagulation resumption is unknown. We aimed to investigate the relationship between reversal therapy and ischemic stroke, between duration off anticoagulation and risk of ischemic strokes or systemic embolism and between timing of anticoagulation resumption and risk of rebleeding and ICH expansion.
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