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:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... As health ... medicine known as “patient engagement.” The patient is doing more than filling out a ... , “There is an increasing emphasis in health care and research on the ...
(Date:10/13/2017)... ... October 13, 2017 , ... ... ‘17, and Jennifer Huggins, PharmD ’17, along with clinical associate professor Janice ... of cardiovascular diseases during the 15th Annual Women’s Health Conference. The SIU ...
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading network ... advocate for action towards gender equality at their inaugural Summit in New York City ... and reached a social audience of over 3 million. To watch the Mobilize Women ...
(Date:10/13/2017)... ... 13, 2017 , ... “The Journey: From the Mountains to the Mission Field”: ... souls in the Philippines. “The Journey: From the Mountains to the Mission Field” is ... Bible. She has taught all ages and currently teaches a class of ladies at ...
(Date:10/12/2017)... Wis. (PRWEB) , ... October 12, 2017 , ... ... standard products to meet the demand of today’s consumer and regulatory authorities worldwide. ... of probiotic experts and tested to meet the highest standard. , These ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... Denmark , Oct. 2, 2017 The Rebound ... in the struggle to reverse the tide of prescription drug ... for regulating their medicine intake and stepping down their dosage ... set to launch in December 2017; the first 100,000 people ... Learn more at http://www.rebound-solution.com/ ...
(Date:9/28/2017)... 28, 2017 Cohen Veterans Bioscience and Early ... of wearable and home sensors for real-time monitoring of ... Foundation, a nonprofit organization focused on disruptive health solutions ... affordable analytical system to record and integrate behavioral, cognitive, ... ...
(Date:9/27/2017)... CAESAREA, Israel and NEW YORK , Sept. ... company with mobile health and big data solutions, today announced that its ... today. Please check your local TV listings for when The Dr. Oz ... ... ninth season this month. ...
Breaking Medicine Technology: