Navigation Links
Patients may not have to stop taking anti-platelets for some surgeries
Date:12/10/2010

Despite the common clinical practice among surgeons to discontinue their patients' anti-platelet therapy prior to surgery, a recent study of patients undergoing carotid endarterectomy (CEA) indicated that this practice may be unnecessary. The study will be published in the December issue of the Annals of Vascular Surgery.

The use of clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis), an antiplatelet agent prescribed for patients with acute myocardial infarction (severe heart attack), recent stroke or peripheral arterial disease, continues to rise with U.S. sales of $3.9 billion in 2007, wrote the authors. As a result, the researchers sought to examine outcomes related to antiplatelet therapy in patients undergoing CEA, which is a surgical procedure that removes plaque from the carotid arteries in the neck to prevent stroke.

"Most surgeons choose to discontinue their patients' use of anti-platelets prior to surgery, despite the lack of scientific evidence," said study author Adnan Z. Rizvi, MD, from the department of vascular and endovascular surgery at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis. "However, studies have found increased bleeding with patients taking Plavix during open-heart surgery, so this surgery is an exception to our findings."

"In our practice, we previously stopped Plavix use prior to CEA. Yet, more recently, we have allowed some of our patients to continue with their anti-platelet therapy before undergoing CEA," explained Rizvi. "We decided to undertake this study to assess whether there were any higher bleeding complications associated with this decision."

For the study, five board-certified vascular surgeons retrospectively analyzed 260 consecutive patients who underwent CEA at the Minneapolis Heart Institute performed by between June 2006 and April 2009. Fifty of these patients were taking clopidogrel during surgery, were compared with nine patients who had their clopidogrel discontinued prior to surgery.

The technique selected for CEA was at the discretion of the operating surgeon, and included endarterectomy with a patch (Dacron, bovine pericardium or vein), angioplasty or eversion endarterectomy.

The researchers found that the patients who were on clopidogrel had a longer operative time as compared with those who were on aspirin alone; however, operative blood loss was not statistically different. Interestingly, most of the bleeding complications that occurred in patients who were on clopidogrel occurred in patients who underwent endarterectomy with a Dacron patch angioplasty.

Based on their findings, Rizvi and colleagues concluded that carotid surgery can be safely performed on patients taking clopidogrel, but there is a higher risk of bleeding complications associated with using a Dacron patch. "However, if other techniques, such as eversion or bovine pericardium patch are used, then there is no different in bleeding complications with patients taking clopidogrel," Rizvi said.

"With the exception of open-heart surgery, we suspect our findings can be translated for other surgeries, but a larger randomized study is warranted to support these conclusions," he concluded.


'/>"/>

Contact: Meghan Bethke
mbethke@mhif.org
612-863-5410
Minneapolis Heart Institute Foundation
Source:Eurekalert

Related medicine news :

1. Circulating tumor cells predicted recurrence, death in patients with early-stage breast cancer
2. Simple fingertip test may identify breast cancer patients at risk for carpal tunnel syndrome
3. Drugs are safe, active in patients normally ineligible for clinical trial
4. Fox Chase researchers uncover new risk factors for brain metastases in breast cancer patients
5. Blood-thinning treatment standards changing for heart patients, new research shows
6. Non-invasive SRT as good as surgery for elderly patients with early lung cancer
7. Drug combination shows promise for newly diagnosed blood cancer patients, study finds
8. Tests between colonoscopies could be lifesaver for high-risk patients
9. Fewer guessing games for lung cancer patients
10. Personalized vaccine for lymphoma patients extends disease-free survival by nearly 2 years
11. JAK inhibitors producing significant response in myelofibrosis patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop a weight ... app plans to fix the two major problems leading the fitness industry today:, ... program , They don’t eliminate all the reasons people quit their exercise program ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... "With 30 ... their specific project," said Christina Austin - CEO of Pixel Film Studios. , ... and all within Final Cut Pro X . Simply select a ProHand generator ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether ... latter, setting the bar too high can result in disappointment, perhaps even self-loathing. However, ... their goal. , Research from PsychTests.com reveals that behind the tendency ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Scientific Sessions in Dallas that it will receive two significant new grants to ... came as PHA marked its 25th anniversary by recognizing patients, medical professionals and ...
(Date:6/24/2016)... TX (PRWEB) , ... June 24, 2016 , ... People ... part in Genome magazine’s Code Talker Award, an essay contest in which patients and ... an award to be presented at the 2016 National Society of Genetic Counselors (NSGC) ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 The vast majority ... outpatient dialysis facility.  Treatments are usually 3 times a ... per visit, including travel time, equipment preparation and wait ... but especially grueling for patients who are elderly and ... skilled nursing and rehabilitation centers for some duration of ...
(Date:6/23/2016)... FRANKLIN, Tenn. , June 23, 2016 ... for automating, integrating and transforming the patient ... launch of several innovative new products and ... depth of its revenue cycle offerings. These ... establish more efficient workflows, remain compliant in ...
(Date:6/23/2016)... 2016  The National Pharmaceutical Council (NPC) today ... policy research organization as its newest member.  ... vice president and chief scientific officer, Mallinckrodt Pharmaceuticals, ... NPC Board of Directors. ... joined us in support of our efforts to ...
Breaking Medicine Technology: