Full-text of the article is available for this locale: Русский.
Abstract
The review presents the clinical guidelines of the Federation of Anaesthesiology and Resuscitation specialists of Russia, revised in 2018. The recommendations are based on a review of publications and modern international guidelines of the British Hematology Standards Committee (BSH, 2016), the European Society of Cardiology in partnership with the European Society of Cardiothoracic Surgeons (ESC and EACTS, 2018), the American Society of Regional Anesthesia and Pain (ASRA, 2018), The European Society of Anesthesiologists (ESA, 2010), as well as a consensus document of an interdisciplinary group of experts of the Russian Federation.
Perioperative management of patients receiving long-term antithrombotic (antiplatelet and / or anticoagulant) therapy may be problematic, as they often need to interrupt antithrombotic therapy before surgery. In this, it is necessary to maintain a balance between the effectiveness of antithrombotic therapy and its safety by minimizing the frequency of both hemorrhagic and thrombotic complications. The recommendations presented in the review are aimed at achieving the strategic goal of perioperative antithrombotic therapy — minimizing the risk of bleeding subject to the minimum necessary antithrombotic potential.
References
- Keeling D., Tait R.C., Watson H. Peri-operative management of anticoagulation and antiplatelet Therapy. British Committee for Standards in Haematology. British Journal of Haematology, 2016; 175: 602–613. DOI: 10.1111/bjh.14344
- Valgimigli M., Bueno H., Byrne R.A., et al. ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 2018; 39: 213–260. DOI: 10.1093/eurheartj/ehx
- Horlocker T., Vandermeuelen E., Kopp S., et al. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition). Reg. Anesth. Pain Med. 2018; 43: 263–309. DOI: 10.1097/AAP.0000000000000763
- Gogarten W., Vandermeulen E., Aken H.V., Kozek S., Llau J.V., Samama C.M. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur. J. Anaesthesiol. 2010; 27: 999–1015. DOI: 10.1097/EJA.0b013e32833f6f6f
- Ревишвили А.Ш., Шляхто Е.В., Замятин М.Н. и др. Особенности оказания экстренной и неотложной медицинской помощи пациентам, получающим прямые оральные антикоагулянты. Согласительный документ междисциплинарной группы экспертов. Вестник аритмологии. 2018; 92: 59–72. DOI: 10.25760/VA-2018-92-59-72
- [Revishvili A.SH., Shlyahto E.V., Zamyatin M.N., et al. Osobennosti okazaniya ehkstrennoj i neotlozhnoj medicinskoj pomoshchi pacientam, poluchayushchim pryamye oral’nye antikoagulyanty. Soglasitel’nyj dokument mezhdisciplinarnoj gruppy ehkspertov. Vestnik aritmologii. 2018; 92: 59–72. DOI: 10.25760/VA-2018-92-59-72. (In Russ)]
- Burger W., Chemnitius J.M., Kneissl G.D., Rucker G. Low-close aspirin for secondary cardiovascular prevention — Cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation — Review and meta-analysis. Journal of Internal Medicine. 2005; 257: 399–414. DOI: 10.1111/j.1365-2796.2005.01477.x
- Singla S., Sachdeva R, Uretsky B.F. The risk of adverse cardiac and bleeding events following noncardiac surgery relative to antiplatelet therapy in patients with prior percutaneous coronary intervention. Journal of the American College of Cardiology. 2012; 60: 2005–2016. DOI: 10.1016/j.jacc.2012.04.062
- Biondi-Zoccai G.G., Lotrionte M., Agostoni P., et al. A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. European Heart Journal. 2006; 27: 2667–674. DOI: 10.1093/eurheartj/ehl334
- Mehran R., Baber U., Steg P.G., et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet. 2013; 382: 1714–1722. DOI: 10.1016/S0140-6736(13)61720-1
- Rossini R., Musumeci G., Capodanno D., et al. (2015) Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery. Results of a multicentre registry. Thromb. Haemost. 2015; 113: 272–282. DOI: 10.1160/TH14-05-0436
- Corredor C., Wasowicz M., Karkouti K., Sharma V. The role of point-of-care platelet function testing in predicting postoperative bleeding following cardiac surgery: a systematic review and meta-analysis. Anaesthesia. 2015; 70, 715–731. DOI: 10.1111/anae.13083
- Колесникова И.М., Ройтман Е.В. Новый метод определения гемостатической способности тромбоцитов на основе тромбоэластографии. Тромбоз, гемостаз и реология. 2016; 67(S3): 203–204.
- [Kolesnikova I.M., Rojtman E.V. Novyj metod opredeleniya gemostaticheskoj sposobnosti trombocitov na osnove tromboehlastografii. Tromboz, gemostaz i reologiya. 2016; 67(S3): 203–204. (In Russ)]
- Kasivisvanathan R., Abbassi-Ghadi N., Kumar S., et al. Risk of bleeding and adverse outcomes predicted by thromboelastography platelet mapping in patients taking clopidogrel within 7 days of non-cardiac surgery. British Journal of Surgery. 2014; 101: 1383–1390. DOI: 10.1002/bjs.9592
- Sousa-Uva M., Storey R., Huber K., et al. Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery. European Heart Journal. 2014; 35: 1510–1514. DOI: 10.1093/eurheartj/ehu158
- Lip G.Y., Nieuwlaat R., Pisters R., et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010; 137(2): 263–272. DOI: 10.1378/chest.09-1584
- Kolh Ph., Wijns W., Danchin N., et al. Guidelines on myocardial revascularization. Eur. J. Cardiothorac. Surg. 2010; 38(Suppl.): 1–52. DOI: 10.1016/j.ejcts.2010.08.019
- Douketis J.D. Perioperative anticoagulation management in patients who are receiving oral anticoagulant therapy: A practical guide for clinicians. Thromb. Res. 2002; 108: 3–13.
- Schulman S., Hwang H.G., Eikelboom J.W., et al. Loading dose vs. maintenance dose of warfarin for reinitiation after invasive procedures: a randomized trial. Journal of Thrombosis and Haemostasis. 2014; 12: 1254–1259. DOI: 10.1111/jth.12613
- Dunn A.S., Turpie A.G. Perioperative management of patients receiving oral anticoagulants: a systematic review. Archives of Internal Medicine. 2003; 163: 901–908. DOI: 10.1001/archinte.163.8.901
- Dunn A.S., Spyropoulos A.C., Turpie A.G. Bridging therapy in patients on longterm oral anticoagulants who require surgery: the Prospective Peri-operative Enoxaparin Cohort Trial (PROSPECT). Journal of Thrombosis and Haemostasis. 2007; 5: 2211–2218. DOI: 10.1111/j.1538-7836.2007.02729.x
- Dentali F., Pignatelli P., Malato A., et al. Incidence of thromboembolic complications in patients with atrial fibrillation or mechanical heart valves with a subtherapeutic international normalized ratio: a prospective multicenter cohort study. American Journal of Hematology. 2012; 87: 384–387.
- Douketis J.D., Spyropoulos A.C., Spencer F.A., et al. Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed.: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines. Chest. 2012; 141: e326S–e350S. DOI: 10.1378/chest.11-2298
- Siegal D., Yudin J., Kaatz S., et al. Periprocedural heparin bridging in patients receiving vitamin K antagonists: systematic review and meta-analysis of bleeding and thromboembolic rates. Circulation. 2012; 126: 1630–1639. DOI: 10.1161/circulationaha.112.1052
- Spyropoulos A.C., Douketis J.D. How I treat anticoagulated patients undergoing an elective procedure or surgery. Blood. 2012; 120: 2954–2962. DOI: 10.1182/blood-2012-06-415943
- Kearon C., Akl E.A. Duration of anticoagulant therapy for deep vein thrombosis and pulmonary embolism. Blood. 2014; 123: 1794–1801. DOI: 10.1182/blood-2013-12-512681
- Sherwood M.W., Douketis J.D., Patel M.R., et al. Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation. 2014; 129, 1850–1859. DOI: 10.1161/circulationaha.113.005754
- Lai A., Davidson N., Galloway S.W., Thachil J. Perioperative management of patients on new oral anticoagulants.[Erratum appears in Br J Surg. 2014 Nov; 101(12): 1624]. British Journal of Surgery. 2014; 101: 742–749.
- Heidbuchel H., Verhamme P., Alings M., et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with nonvalvular atrial fibrillation. Europace. 2015; 17, 1467–1507.
- Lecompte T, Hardy J. Antiplatelet agents and perioperative bleeding. Canadian Journal of Anaesthesia. 2006; 53: S103–S112.
- Kozek-Langenecker S.A., Ahmed A.B., Afshari A., et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur. J. Anaesthesiol. 2017; 34: 332–395. DOI: 10.1097/EJA.0000000000000630
- Rossaint R. et al. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Critical Care. 2016; 20: 100. DOI: 10.1186/s13054-016-1265-x
- Refaai M.A., Goldstein J.N., Milling T.J., et al. Randomized phase IIIb study of rapid vitamin K antagonist reversal in patients requiring an urgent surgical procedure: Four-factor prothrombin complex concentrate is superior to plasma. Blood (ASH Annual Meeting Abstracts). 2013; 122: 3588.
- Goldstein J.N., Refaai M.A., Milling T.J., et al. Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial. Lancet. 2015; 385: 2077–2087. DOI: 10.1016/S0140-6736(14)61685-8
- Eikelboom J.W., Kozek-Langenecker S., Exadaktylos A., et al. Emergency care of patients receiving non-vitamin K antagonist oral anticoagulation. British Journal of Anesthesia. 2018; 120(4): 645–656. DOI: 10.1016/j.bja.2017.11.082
- American Society of Anesthesiologists Task Force on Perioperative Blood Management. Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task force on perioperative blood management. Anesthesiology. 2015; 122: 241–275. DOI: 10.1097/ALN.0000000000000463
- Chang D.N., Dager W.E., Chin A.I. Removal of dabigatran by hemodialysis. American Journal of Kidney Diseases. 2013; 61: 487–489. DOI: 10.1053/j.ajkd.2012.08.047
- Chai-Adisaksopha C., Hillis C., Lim W., et al. Hemodialysis for the treatment of dabigatran associated bleeding: a case report and systematic review. Journal of Thrombosis and Haemostasis. 2015; 13: 1790–1798. DOI: 10.1111/jth.13117
- Vilahur G., Choi B.G., Zafar M.U., et al. Normalization of platelet reactivity in clopidogrel-treated subjects. Journal of Thrombosis & Haemostasis. 2007; 5: 82–90.
- Li C., Hirsh J., Xie C., et al. Reversal of the anti-platelet effects of aspirin and clopidogrel. Journal of Thrombosis and Haemostasis. 2012; 10: 521–528.
- Thiele T., Sumnig A., Hron G., et al. Platelet transfusion for reversal of dual antiplatelet therapy in patients requiring urgent surgery: a pilot study. Journal of Thrombosis and Haemostasis. 2012; 10: 968–971.
- Llau J.V., De Andres J., Gomar C., et al. Anticlotting drugs and regional anaesthetic and analgesis technigues: comparative update of the safety recommendatios. European Journal of Anaesthesiology. 2007; 24: 387–398.
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