Survey of the management of perioperative bridging of anticoagulation and antiplatelet therapy in neurosurgery

Acta neurochirurgica
Marco SkardellyFlorian H Ebner

Abstract

A growing number of patients on anticoagulation or antiplatelet therapy (APT) are planned for elective surgery. The management of perioperative anticoagulation and APT is challenging because it must balance the risk of thromboembolism and bleeding, and specific recommendations for the management of bridging in neurosurgical patients are lacking. We surveyed German neurosurgical centers about their management of perioperative bridging of anticoagulation and APT to provide an overview of the current bridging policy. From April to August 2016, all German neurosurgical departments were invited to participate in the survey. We used SurveyMonkey to compose ten questions and to conduct the survey, and we defined three different approaches for the perioperative management of patients on a preexisting medication: medication will be discontinued (A) with perioperative "bridging" and (B) without perioperative bridging, or (C) medication will be continued perioperatively. Out of 141 respondents, 84 (60%) partially and 77 (55%) fully completed the questionnaire. No defined policy for the perioperative management of anticoagulation and APT was established in 60.7% (51/84) of participating centers. The perioperative management of anticoagulat...Continue Reading

References

Oct 9, 1999·Neurosurgery·B E Lazio, J M Simard
Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
Aug 31, 2012·Blood·Alex C Spyropoulos, James D Douketis
May 31, 2013·The New England Journal of Medicine·Todd H BaronRobert D McBane
Jul 23, 2013·Journal of Thrombosis and Thrombolysis·Leslie SkeithMichael J Kovacs
Dec 19, 2013·Circulation·Sumeet S ChughChristopher J L Murray
Apr 1, 2014·The New England Journal of Medicine·P J DevereauxUNKNOWN POISE-2 Investigators
Jun 23, 2015·The New England Journal of Medicine·James D DouketisUNKNOWN BRIDGE Investigators

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Citations

Jul 16, 2019·Journal of Neurosurgical Anesthesiology·John Porter, Judith Dinsmore
Aug 4, 2021·Acta neurochirurgica·Joachim RungeJoachim K Krauss

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