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Recurrent embolic strokes due to antiphospholipid syndrome and non-bacterial thrombotic endocarditis in a patient with basal cell carcinoma
CONCLUSION: Outside of SLE and antiphospholipid syndrome, NBTE is a rare and underdiagnosed disease associated with thromboembolic events. Adequate anticoagulation is a cornerstone of its treatment. Anticoagulation management during perioperative care and valve surgery deserves specific attention and helps to protect the patient from embolic complications. In the case of stroke and thromboembolic events of unclear cause or suspected NBTE, echocardiography and thrombophilia assessments including an immunological workup are recommended.PMID:37170311 | PMC:PMC10176810 | DOI:10.1186/s13019-023-02266-6
Source: Hand Surgery - May 11, 2023 Category: Surgery Authors: Julianna Svantner Luc Lavanchy Ania Labouch ère Source Type: research

Risk of bleeding complications per different perioperative antithrombotic regimes during carotid endarterectomy: a national registry analysis
CONCLUSION: The effectiveness and safety of DAPT did not differ from single antiplatelet therapy (SAPT) in patients undergoing CEA and needs further evaluation in prospective studies. Considering additional data from the literature and guideline recommendations DAPT should be started immediately after stroke until 30 days after CEA followed by SAPT, due to possible reduction in the risk of recurrency.PMID:36031046 | DOI:10.1016/j.ejvs.2022.08.020
Source: PubMed: Eur J Vasc Endovasc ... - August 28, 2022 Category: Surgery Authors: Simone Ja Donners Joost M Mekke Eline S van Hattum Raechel J Toorop Gert J de Borst Dutch Audit for Carotid Interventions (DACI) Collaborators Source Type: research

Efficacy and safety of non-vitamin K antagonist oral anticoagulants combined with antiplatelet drugs for patients with peripheral artery disease: A systematic review and meta-analysis of randomized controlled trials
CONCLUSIONS: In summary, for peripheral artery disease patients, a combination of NOACs plus antiplatelet drugs may offer additional benefit in reducing ischemic stroke outcome, yet it may increase the risk of bleeding.PMID:33759649 | DOI:10.1177/17085381211003694
Source: Vascular - March 24, 2021 Category: Surgery Authors: Meina Lv Shaojun Jiang Tingting Wu Wenjun Chen Jinhua Zhang Source Type: research

Gamma-glutamyl transferase as a risk factor for mortality and cardiovascular events in older adults - results from a prospective cohort study in a primary care setting (getABI).
Conclusions: In a primary care setting, GGT values have a significant association with overall mortality and cerebrovascular events, but not with CHD events in elderly patients. PMID: 30994055 [PubMed - as supplied by publisher]
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - April 16, 2019 Category: Surgery Authors: Kreutzer F, Krause D, Klaassen-Mielke R, Trampisch HJ, Diehm C, Rudolf H Tags: Vasa Source Type: research

Safety and efficacy of direct acting oral anticoagulants and vitamin K antagonists in nonvalvular atrial fibrillation - a network meta-analysis of real-world data.
CONCLUSIONS: DOACs were at least as efficacious as VKAs. In terms of safety endpoints, DOACs performed better under real-world conditions than in RCTs. The current real-world data showed that differences in efficacy and safety, despite generally low event rates, exist between DOACs. Knowledge about these differences in performance can contribute to a more personalized medicine. PMID: 30376416 [PubMed - as supplied by publisher]
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - November 1, 2018 Category: Surgery Authors: Hirschl M, Kundi M Tags: Vasa Source Type: research

Antithrombotic treatment in peripheral artery disease.
Abstract This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke. In symptomatic PAD, dual antiplatelet therapy (DAPT) with clopidogrel and aspirin does not prov...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - November 21, 2017 Category: Surgery Authors: Olinic DM, Tataru DA, Homorodean C, Spinu M, Olinic M Tags: Vasa Source Type: research

Use of idarucizumab for dabigatran reversal in patients with non-valvular atrial fibrillation undergoing emergency surgical repair of strangulated femoral hernia
We report a case of a 61-year-old woman with history of NVAF on dabigatran, presented to the emergency department with a strangulated right femoral hernia causing small bowel obstruction, where idarucizumab was administered before surgery. The patient had received her last dose of dabigatran 4 hours before presenting to the emergency department and her activated partial thromboplastin time was over the upper limit of reference. Surgery followed about one hour after the administration of idarucizumab and surgeon reported normal perioperative haemostasis. The patient had a normal recovery, received parenteral anticoagulation...
Source: Hellenic Journal of Surgery - April 1, 2017 Category: Surgery Source Type: research

Direct oral factor Xa inhibitors for the prevention of non-central nervous systemic embolism patients with non-valvular atrial fibrillation - a systematic review and meta-analysis.
CONCLUSIONS: As a drug class, direct oral factor Xa inhibitors do not reduce the incidence of non-central nervous systemic embolism (or ischaemic stroke) in patients with non-valvular atrial fibrillation. Selecting drugs for the prevention of non-central nervous systemic embolism in patients with non-valvular atrial fibrillation should be based on individual drug efficacy data, rather than class data. PMID: 27428497 [PubMed - in process]
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - June 30, 2016 Category: Surgery Authors: Gandara V, Vazquez F, Gandara E Tags: Vasa Source Type: research

Heparins – DOACS – VKA
Patients with cancer are at increased risk of venous thromboembolism (VTE). At the same time they have often an underlying bleeding risk. That can often make decisions surrounding the administration of anticoagulants complicate. Individual risk-benefit calculation is necessary. During hospital stage the patients get, if there are no contraindications, a medical VTE prophylaxis with low molecular weight heparin (LMWH). Whereas outpatients don`t get a prophylaxis because they are at low risk of thromboembolism. If additional risk factor for VTE exists a decision for medical VTE prophylaxis should be taken into account. In pa...
Source: Phlebologie - December 2, 2015 Category: Surgery Source Type: research

Perioperative management of patients on new oral anticoagulants
ConclusionManagement of NOACs in elective and emergency conditions requires knowledge of time of last intake of drug, current renal function and the planned procedure in order to assess the overall risk of bleeding. Currently no antidote exists to reverse the effects of these drugs.
Source: British Journal of Surgery - April 29, 2014 Category: Surgery Authors: A. Lai, N. Davidson, S. W. Galloway, J. Thachil Tags: Review Source Type: research