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Specialty: Surgery
Condition: Bleeding

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Total 190 results found since Jan 2013.

Cost Analysis of Direct Oral Anticoagulants Compared with Warfarin in Patients with Blunt Traumatic Intracranial Hemorrhages.
Abstract Direct oral anticoagulants (DOACs) are rapidly gaining popularity as alternatives to warfarin in the prevention of stroke or systemic embolic events because of the simplicity of their dosing and lack of monitoring requirement. Many physicians feared that these novel agents would be cost-prohibitive not only in their administration but also in their sequelae of bleeding, given the few reversal agents available. Whereas the medication itself is more expensive than traditional warfarin, the total cost of a hospital admission has not been compared between patients on DOACs and warfarin who have sustained a bl...
Source: The American Surgeon - June 1, 2018 Category: Surgery Authors: Lamb LC, DiFiori M, Comey C, Feeney J Tags: Am Surg Source Type: research

Does surgical technique influence the postoperative hemodynamic disturbances and neurological outcomes in carotid endarterectomy?
CONCLUSIONS: E-CEA was associated with significant reduction in operative time and cross-clamping time however, increases postoperative bleeding. No difference was noted for postoperative stroke and blood pressure distortion between E-CEA and C-CEA. PMID: 29701500 [PubMed - as supplied by publisher]
Source: Acta Chirurgica Belgica - April 28, 2018 Category: Surgery Tags: Acta Chir Belg Source Type: research

Catheter-directed interventions compared with systemic thrombolysis achieve improved ventricular function recovery at a potentially lower complication rate for acute pulmonary embolism
Conclusions CDIs provide improved recovery of right ventricular function compared with ST. Major bleeding and stroke complications may be lower, but larger studies are needed to validate this. CDIs are complementary to ST, and their use should be individualized on the basis of the patients' clinical presentation, risk profile, and local resources.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - April 1, 2018 Category: Surgery Source Type: research

Safety and Efficacy of Femoral Artery Closure with the FemoSeal Device After Cerebral Thrombectomy Using an 8 French Sheath.
CONCLUSION: The use of the FemoSeal device to close an 8F access sheath puncture site is feasible and safe, with a low complication rate. PMID: 29550254 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 14, 2018 Category: Surgery Authors: Chivot C, Deramond H, Bouzerar R, Yzet T Tags: Eur J Vasc Endovasc Surg Source Type: research

Perioperative handling of anticoagulation.
Abstract A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms. Thu...
Source: Der Chirurg - January 10, 2018 Category: Surgery Authors: Lock JF, Wagner J, Luber V, Dietz UA, Lichthardt S, Matthes N, Krajinovic K, Germer CT, Knop S, Wiegering A Tags: Chirurg Source Type: research

A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery
Conclusions: Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use.
Source: Annals of Surgery - December 22, 2017 Category: Surgery Tags: Features Source Type: research

Outcomes of Patients with Critical Limb Ischaemia in the EUCLID Trial.
CONCLUSIONS: Nearly 5% of patients enrolled in EUCLID had CLI at baseline. Milder forms of CLI dominated, a result of the trial design. Patients with CLI had a significantly higher rate of cardiovascular mortality and morbidity versus those without CLI. Further efforts are required to reduce the risk of cardiovascular events in PAD, especially in patients with CLI. CLINICALTRIALS.GOV: NCT01732822. PMID: 29273390 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - December 19, 2017 Category: Surgery Authors: Norgren L, Patel MR, Hiatt WR, Wojdyla DM, Fowkes FGR, Baumgartner I, Mahaffey KW, Berger JS, Jones WS, Katona BG, Held P, Blomster JI, Rockhold FW, Björck M, EUCLID Steering Committee and Investigators Tags: Eur J Vasc Endovasc Surg 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

Impact of the FloTrac/Vigileo < sup > TM < /sup > Monitoring on Intraoperative Fluid Management and Outcome after Liver Resection
Conclusions: Patients who received a monitored fluid therapy experienced a safer outcome.Dig Surg
Source: Digestive Surgery - October 26, 2017 Category: Surgery Source Type: research

Open Thoracic and Thoraco-abdominal Aortic Repair in Patients with Connective Tissue Disease.
CONCLUSION: Open TAA(A) repair is a durable therapy for patients with CTD. Often being performed as revision surgery, it can be associated with relevant risks and should therefore be reserved for specialised centres. Staged procedures and thus reducing operating time, if applicable, should be preferred. PMID: 28916127 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - September 12, 2017 Category: Surgery Authors: Keschenau PR, Kotelis D, Bisschop J, Barbati ME, Grommes J, Mees B, Gombert A, Peppelenbosch AG, Schurink GWH, Kalder J, Jacobs MJ Tags: Eur J Vasc Endovasc Surg Source Type: research

A critical note on protamine use in carotid endarterectomy
Two recent meta-analyses investigated the risks and benefits of heparin reversal by protamine after carotid endarterectomy (CEA).1,2 They found that heparin reversal with protamine reduces the risk for reoperation due to bleeding without an increased risk of stroke, myocardial infarction, or death. Yet, we would like to address the hemostatic and hemodynamic effects of protamine.
Source: Journal of Vascular Surgery - August 22, 2017 Category: Surgery Authors: Michael I. Meesters, Christa Boer Tags: Letter to the Editor Source Type: research

Impact of health utility after thrombotic complications following total hip and knee arthroplasty
ConclusionObjective calculation of both the benefit and risks of anticoagulation in the post‐operative patient is significantly altered by including the effect on patient's quality of life utility value. Therapeutic anticoagulation in some common situations is probable to be of more detriment than benefit when considering health utility.
Source: ANZ Journal of Surgery - July 31, 2017 Category: Surgery Authors: Bikram Karmakar Tags: Original Article Source Type: research

PC164 Fast-Track Thrombolysis for Acute Lower Extremity In-Stent Occlusions: A Novel Approach to Minimize Complications of Standard Thrombolytic Therapy
The role of catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity ischemia may require prolonged periods of time to achieve successful lysis. Prolonged thrombolysis infusion has demonstrated increased incidence of intracranial bleeding, stroke, and local complications. It is expensive and increases hospital length of stay. To minimize these potentially negative outcomes, we developed a fast track approach (FTA) that included the use of aggressive balloon angioplasty and stenting before the thrombus was completely lysed.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Syed Ali Rizvi, Anil Hingorani, Enrico Ascher, Natalie Marks Tags: C10: Poster Competition 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

Management of anticoagulation with rivaroxaban in trauma and acute care surgery: Complications and reversal strategies as compared to warfarin therapy
CONCLUSION: Reversal of rivaroxaban was less common and required fewer agents, whereas bleeding complications and hemostatic interventions do not seem to be different between these AC types. LEVEL OF EVIDENCE: Therapeutic study, level II.
Source: Journal of Trauma and Acute Care Surgery - February 23, 2017 Category: Surgery Tags: Original Articles Source Type: research