Periprocedural bridging therapy in patients receiving chronic oral anticoagulation therapy.

摘要: ABSTRACTBackground: In patients receiving chronic oral anticoagulation with vitamin K antagonists (VKAs) it may be necessary to temporarily discontinue VKA therapy allow surgery or other invasive procedures performed, as maintaining treatment increase the risk of bleeding during procedure. This, however, creates a clinical dilemma, since discontinuing VKAs place patient at thromboembolism.Scope: We undertook systematic narrative review on anticoagulation, requiring periprocedural bridging heparin procedures.Findings and recommendations: For temporary discontinuation VKA, current guidelines recommend use ‘bridging’ unfractionated (UFH) low-molecular-weight (LMWH) in considered intermediate-to-high thromboembolism, such those prosthetic heart valves atrial fibrillation. Recent studies show that LMWHs are associated l...