Navigation Links
Safe for stroke patients to continue blood thinners before minor surgical procedures
Date:5/29/2013

MAYWOOD, Il. - Many patients who have experienced strokes or mini strokes take blood thinners such as aspirin or warfarin (Coumadin) to reduce the risk of blood clots that can cause strokes.

This can pose a dilemma when a patient needs to undergo a surgical procedure, because blood thinners can increase the risk of bleeding. But a new guideline from the American Academy of Neurology advises that it is likely safe to continue taking blood thinners before minor procedures such as dental procedures, cataract surgery or dermatologic procedures. The guideline is published in Neurology, the official scientific journal of the American Academy of Neurology.

"This guideline is expected to be useful to neurologists, primary care physicians, surgeons, dentists and other healthcare providers caring for these patients," said Dr. Jose Biller, chair of the Department of Neurology of Loyola University Medical Center. Dr. Biller is one of nine co-authors of the guideline; three other authors also have Loyola ties.

The physicians evaluated evidence from 133 studies. Among their findings:

  • There's a high likelihood that taking aspirin or warfarin before dental procedures will not increase the bleeding risk.
  • Aspirin is likely to not increase bleeding risk before such procedures as cataract surgery, dermatologic procedures, prostate biopsy and carpal tunnel syndrome surgery. Similarly, warfarin likely will not increase the bleeding risk in dermatologic procedures and invasive ocular anesthesia.
  • Aspirin possibly does not increase bleeding risk for such procedures as retinal surgery and ultrasound-guided biopsy.
  • Aspirin is likely to increase the bleeding risk in orthopaedic hip procedures.

The authors provide three hypothetical examples of how the guideline could be applied:

  • A 65-year-old man who had a stroke one year ago is due for routine colonoscopy screening. Given that the patient may not need to have a polyp removed during the colonoscopy -- and there's only a 2 percent chance of bleeding even if a polyp is removed -- his neurologist recommends he continue taking aspirin.
  • A 70-year-old breast cancer patient who had a previous stroke is undergoing a mastectomy. There is little research on the bleeding risk of taking aspirin before such invasive procedures. So to be safe, the neurologist and patient decide to discontinue aspirin seven days before surgery, and restart it the day after surgery.
  • A 60-year-old man who's had a stroke is undergoing cataract surgery. The neurologist reviews the guideline and finds the risks associated with warfarin during ophthalmologic procedures have not been established with sufficient precision. Nevertheless, the patient would rather face the risk of increased bleeding than risk another stroke. So the ophthalmologist, neurologist and patient decide to continue warfarin during the cataract surgery.

First author Dr. Melissa J. Armstrong began work on the guideline while she was a neurology resident at Loyola. She now is an assistant professor at the University of Maryland School of Medicine. Other guideline authors with Loyola ties are Dr. Jose Biller and Dr. Michael Schneck, professors in the Department of Neurology of Loyola University Chicago Stritch School of Medicine and Dr. Rima Dafer, a former associate professor of Neurology at Loyola who now is at NorthShore University HealthSystem.


'/>"/>

Contact: Jim Ritter
jritter@lumc.edu
708-216-2445
Loyola University Health System
Source:Eurekalert

Related medicine news :

1. Research by the Montana Center for Work Physiology and Exercise Metabolism Proves Heat Stroke Death Can Occur Even When Properly Hydrated
2. Intermountain Vein Center Announces Groundbreaking Guidelines in Treatment of Acute Ischemic Stroke
3. Integrated stroke care system results in fewer deaths, discharges to long-term care facilities
4. Regenerating spinal cord fibers may be treatment for stroke-related disabilities
5. For Stroke Awareness Month, Dr. Andrew Satlin is Raising Awareness of the Connections Between Gum Disease and Stroke and Offers Encino, CA Laser Gum Surgery for Treatment
6. Cost of Treating Strokes in U.S. Could Soar to $180B Annually by 2030: Report
7. Stroke patients respond similarly to after-stroke care, despite age difference
8. New Emergency Stroke Treatments Can Save and Restore Lives if Patients Act Quickly and Call 911
9. Depression May Boost Stroke Risk in Middle-Aged Women, Too
10. PolyU Researchers Develop Novel Brain Training Device to Reconnect the Brain and Paralyzed Limb After Stroke
11. How to Quickly Spot Signs of Stroke: Experts
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... Carolina (PRWEB) , ... June 26, 2016 , ... ... of a new product that was developed to enhance the health of felines. The ... centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... ... The temporary closing of Bruton Memorial Library on June 21 due to a possible lice ... overlooked aspect of head lice: the parasite’s ability to live away from a human host, ... a necessary one in the event that lice have simply gotten out of control. , ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
(Date:6/24/2016)... ... 2016 , ... Marcy was in a crisis. Her son James, eight, was out of control. ... and physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. ... rocks at my other children and say he was going to kill them. If ...
(Date:6/24/2016)... Rhinebeck, NY (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of ... of companies that call for a minimum wage raise to $12 an hour by 2020 ... wage. This will restore the lost value of the minimum wage, assure the wage floor ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... RIDGE, Ill. and INDIANAPOLIS ... of students receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship ... The 2016 scholarship winners, announced today online at ... to let type 1 diabetes stand in the way ... Diabetes has supported the Foundation,s scholarship program since 2012, ...
(Date:6/23/2016)... , June 23, 2016  Guerbet announced today ... Inc.,s Supplier Horizon Award . One ... Guerbet was recognized for its support of Premier members ... through clinical excellence, and commitment to lower costs. ... receive this recognition of our outstanding customer service from ...
(Date:6/23/2016)... 23, 2016  Experian Health, the healthcare ... the patient payment and care experience, today ... products and services that will enhance the ... offerings. These award-winning solutions will enable healthcare ... compliant in an ever-changing environment and redefine ...
Breaking Medicine Technology: