Vnitr Lek 2009, 55(3):272-275

Preparation of patients on anticoagulant treatment for invasive surgery

M. Brejcha1,*, J. Gumulec2, M. Penka3, D. Klodová1, M. Wróbel1, E. Bogoczová1
1 Hematologické oddělení, Onkologické centrum J. G. Mendela Nový Jičín, přednosta prim. MUDr. Martin Brejcha
2 Hemato-onkologické a transfuzní centrum FN Ostrava, přednosta prim. MUDr. Jaromír Gumulec
3 Oddělení klinické hematologie FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Miroslav Penka, CSc.

The management of warfarin therapy in patients undergoing surgery or other invasive procedures involves a balance between the risk of hemorrhage, and the risk of thrombosis. Risk of hemorrhage and the trombosis depends on the type of procedure and on pre-existing conditions. Procedures with low risk of hemorrhage (dental, dermatologic or ophtalmologic procedures, endoscopy) can be provided with continuing anticoagulant therapy. Surgery with high hemorrhagic risk need stop warfarin and start bridging anticoagulant therapy, such as unfractionated heparin or low molecular weight heparin, prior and after surgery. In patients requiring emergency surgery, vitamin K, prothrombin complex concentrate or fresh frozen plasma can be used to improve coagulation.

Keywords: anticoagulant therapy; bridging therapy

Received: February 2, 2009; Published: March 1, 2009  Show citation

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Brejcha M, Gumulec J, Penka M, Klodová D, Wróbel M, Bogoczová E. Preparation of patients on anticoagulant treatment for invasive surgery. Vnitr Lek. 2009;55(3):272-275.
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