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Specialty: Anesthesiology
Condition: Thrombosis

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Total 264 results found since Jan 2013.

Code Stroke After Cardiac Surgery: Can We Make a Difference?
IN AN editorial in the Journal of Cardiovascular and Thoracic Anesthesia, Kashani et al. reported their systematic review on intraarterial thrombolytic (IAT) and endovascular mechanical treatment (EMT) for stroke after cardiac surgery.1 Unfortunately, few conclusions about the efficacy of either approach could be drawn because of the sparsity of data —a total of 33 patients were reported in case series or case reports. Complete reperfusion was possible in 26% of the IAT group, with 42% of patients also receiving EMT due to poor initial results.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 24, 2020 Category: Anesthesiology Authors: Daniel Bainbridge Tags: Editorial Source Type: research

Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries A Retrospective Cohort Analysis
Conclusions An active cannabis use disorder is associated with an increased perioperative risk of myocardial infarction.Editor ’s PerspectiveWhat We Already Know about This TopicCannabis is known to have cardiovascular and psychoactive effectsThe association between active cannabis use disorder and postoperative outcomes remains unclearWhat This Article Tells Us That Is NewIn the United States, administrative data demonstrate that cannabis use disorder has increased in prevalence from 2010 to 2015Active cannabis use disorder is not associated with a change in overall perioperative morbidity, mortality, length of stay, or...
Source: Anesthesiology - March 10, 2020 Category: Anesthesiology Source Type: research

Incidence of Thromboembolic Events in Oncology Patients Receiving Intraoperative Tranexamic Acid During Orthopedic Surgery: A Retrospective Review at a Comprehensive Cancer Center
We present a retrospective review of 104 patients with an oncologic diagnosis who received intraoperative tranexamic acid during orthopedic surgery. Overall, complication rates were low, including deep vein thrombosis (1.0%), pulmonary embolism (4.8%), stroke (0%), and myocardial infarction (0%). This preliminary evidence shows that antifibrinolytics such as tranexamic acid may be considered perioperatively in oncology patients without increased risk of thromboembolic events; however, further prospective trials are encouraged.
Source: A&A Case Reports - January 15, 2020 Category: Anesthesiology Tags: Innovation Source Type: research

CHA2DS2-VASc Score and In-Hospital Mortality in Critically Ill Patients With New-Onset Atrial Fibrillation
To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF).
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2019 Category: Anesthesiology Authors: Kunal Karamchandani, Robert S. Schoaps, Thomas Abendroth, Zyad J. Carr, Tonya S. King, Anthony Bonavia Tags: Original Article Source Type: research

Four-factor Prothrombin Complex Concentrate for the Management of Patients Receiving Direct Oral Activated Factor X Inhibitors
Direct oral anticoagulants (DOACs) have been approved for the prevention of stroke and systemic embolism in atrial fibrillation, treatment and secondary prevention of venous thromboembolism (VTE), and thromboprophylaxis after major orthopedic surgery. DOACs achieve anticoagulation by inhibiting specific coagulation factors; apixaban, betrixaban, edoxaban, and rivaroxaban inhibit activated factor X, whereas dabigatran inhibits thrombin (factor IIa). In contrast to vitamin K antagonists such as warfarin, DOACs have more predictable pharmacokinetics and pharmacodynamics and fewer interactions with other medications and food, ...
Source: Anesthesiology - October 15, 2019 Category: Anesthesiology Source Type: research

Perioperative Management of the Direct-Acting Oral Anticoagulants.
Abstract Since the 1950s, warfarin has been the most commonly prescribed anticoagulant in the prevention of stroke-related thromboembolism. Beginning in 2008, direct-acting oral anticoagulants (DOACs) began to replace warfarin. Although the DOACs had a greater safety profile, approved reversal agentsfor use in emergent/excessive hemorrhage did not exist. This course reviews the perioperative management of the DOACs. PMID: 31587718 [PubMed - in process]
Source: AANA Journal - July 31, 2019 Category: Anesthesiology Authors: Kane TD, Tubog TD Tags: AANA J Source Type: research

Anesthesiological management in endovascular stroke treatment.
Abstract Early recanalization of the closed cerebral arteries after acute ischemic stroke (AIS) is the only treatment to minimize long-term disability and to reduce the associated morbidity and mortality. For a long time the only proven causal treatment of AIS was intravenous thrombolysis; however, after the publication of a series of randomized prospective studies concerning endovascular mechanical thrombectomy using stent retriever systems after AIS, new guidelines were published. It was found that endovascular treatment (EVT) dramatically improves the outcome of eligible patients. The stent retriever enables ...
Source: Der Anaesthesist - July 18, 2019 Category: Anesthesiology Authors: Theilen HJ, Gerber JC Tags: Anaesthesist Source Type: research

Left Atrial Thrombus Formation in a Patient With Severe Non-rheumatic Mitral Stenosis After Mitral Valve Repair Receiving Dual Antiplatelet Therapy: A Clinical Challenge
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 10, 2019 Category: Anesthesiology Authors: Michael Essandoh, Amir Elhassan, Thomas J. Papadimos, Brandon Pruett, Gregory D. Rushing Tags: Diagnostic Dilemma Source Type: research

Efficacy and safety of erythropoietin and iron therapy to reduce red blood cell transfusion in surgical patients: a systematic review and meta-analysis
ConclusionAdministration of ESA and iron therapy reduced the risk for RBC transfusion compared with iron therapy alone in patients undergoing cardiac and non-cardiac surgery. Nevertheless, publication bias and heterogeneity reduces the confidence of the finding. Although the analysis was probably under-powered for some outcomes, no difference in the incidence of serious adverse events was observed with ESA and iron compared with iron alone. Further large prospective trials are required to confirm these findings.
Source: Canadian Journal of Anesthesia - May 8, 2019 Category: Anesthesiology Source Type: research

Efficacy and safety of erythropoietin and iron therapy to reduce red blood cell transfusion in surgical patients: a systematic review and meta-analysis.
CONCLUSION: Administration of ESA and iron therapy reduced the risk for RBC transfusion compared with iron therapy alone in patients undergoing cardiac and non-cardiac surgery. Nevertheless, publication bias and heterogeneity reduces the confidence of the finding. Although the analysis was probably under-powered for some outcomes, no difference in the incidence of serious adverse events was observed with ESA and iron compared with iron alone. Further large prospective trials are required to confirm these findings. PMID: 30924000 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - March 27, 2019 Category: Anesthesiology Authors: Kei T, Mistry N, Curley G, Pavenski K, Shehata N, Tanzini RM, Gauthier MF, Thorpe K, Schweizer TA, Ward S, Mazer CD, Hare GMT Tags: Can J Anaesth Source Type: research

Percutaneous Coronary Artery Revascularization and Transcatheter Aortic Valve Replacement: Is There a Who, Why, and When?
WITH A PREVALENCE in aortic stenosis (AS) patients of 25% to 50%, concomitant coronary artery disease (CAD) has proven to be an independent risk factor for patients undergoing transcatheter aortic valve replacement (TAVR).1 Currently there is no standard- or guideline-driven approach for these patients, and many new challenges have emerged in this population. In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Bacigalupo et al.2 report a case of a patient with recent percutaneous coronary intervention (PCI) for obstructive CAD who underwent TAVR complicated by in-stent thrombosis and an ischemic stroke ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 20, 2019 Category: Anesthesiology Authors: Oscar D. Aljure, Michael Fabbro Tags: Editorial Source Type: research

Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report
We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed. Fibrinolytic coagulopathy was successfully managed by monitoring fibrinogen levels and with the administration of cryoprecipitate and tranexamic acid.
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Decannulation of a Ventricular Assist Device
BECAUSE OF the donor organ shortage, an increasing number of patients with advanced heart failure are receiving ventricular assist devices (VADs) as a bridge to transplantation or as a destination therapy.1 Patients with advanced heart failure who receive a VAD have significantly greater survival rates compared with those who are treated with only medication.2 However, short- and long-term complications of VADs still are a major concern.3 There are perioperative risks attributed to patient comorbidities; risks of surgery and anesthesia; and postoperative risks such as bleeding, thrombosis, stroke, infection, right ventricu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 4, 2018 Category: Anesthesiology Authors: Tuan-Yen Wu Tags: Case Report Source Type: research

Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR)
Publication date: Available online 5 January 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet, P. Albaladejo, S. Belisle, N. Blais, F. Bonhomme, A. Borel-Derlon, J.Y. Borg, J.-L. BossonAbstractThe French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anaesthesia and Intensive Care Medicine...
Source: Anaesthesia, Critical Care and Pain Medicine - July 10, 2018 Category: Anesthesiology Source Type: research