scholarly journals The Risk of Bleeding Complications in Intra-Articular Injections and Arthrocentesis in Patients on Novel Oral Anticoagulants: A Systematic Review

Cureus ◽  
2021 ◽  
Author(s):  
Muhammad Yasir Tarar ◽  
Xin Yin Choo ◽  
Shoaib Khan
Keyword(s):  
Systematic Review ◽  
Oral Anticoagulants ◽  
Novel Oral Anticoagulants ◽  
Bleeding Complications ◽  
Risk Of Bleeding

A New Arrhythmia

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Lower Risk ◽  
Stroke Risk ◽  
Recurrent Stroke ◽  
Oral Anticoagulants ◽  
Novel Oral Anticoagulants ◽  
Bleeding Complications ◽  
The Novel ◽  
Risk Of Bleeding

Atrial fibrillation is a potent risk factor for stroke. Anticoagulation significantly lowers recurrent stroke risk in patients with atrial fibrillation. The novel oral anticoagulants offer options in addition to warfarin, and they are associated with lower risk of bleeding complications.

Abstract W P223: Treatment of Cervical Artery Dissection with Different Antithrombotic Agents

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Fan Z Caprio ◽  
Deborah Bergman ◽  
Yvonne Curran ◽  
Richard Bernstein ◽  
Shyam Prabhakaran
Keyword(s):  
Recurrent Stroke ◽  
Oral Anticoagulants ◽  
Antiplatelet Agents ◽  
Novel Oral Anticoagulants ◽  
Bleeding Complications ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
Hemorrhagic Complications

Background and Purpose: Antiplatelet agents and anticoagulants are both accepted and commonly used agents for treatment of cervical artery dissection (CAD), though randomized clinical trials are lacking. We report on the use of novel oral anticoagulants for CAD and compared their efficacy and safety to traditional anticoagulants. Methods: We retrospectively identified patients diagnosed with CAD at a single academic center between July 2010 and December 2012. Patients treated with novel anticoagulants (NOAC: dabigatran or rivaroxaban), other anticoagulants (AC: warfarin, heparin, or low molecular weight heparin), or antiplatelet agents (AP: aspirin, clopidogrel, or aspirin-dypyridamole) were compared for baseline characteristics, recurrent stroke, vessel recanalization on follow-up, and bleeding complications using Fisher’s exact and student t-tests. Results: During the study period, 110 patients with CAD were included, of whom 20 (18%), 61 (55%), and 29 (26%) were treated initially with a NOAC, AC, and AP, respectively. Clinical follow-up was available in 98 (89.1%) patients while radiographic follow-up was available in 88 (80%) patients. NOAC-treated patients were more likely to have presented with ischemic stroke symptoms (90% vs. 55.7%, p=0.007) but had similar rates of severe stenosis (60% vs. 53.3%, p=0.522) and intraluminal/intramural thrombus (70% vs. 57.6%, p=0.327) on initial vascular imaging compared to AC patients. There was 1 recurrent stroke in the NOAC group and 1 in the AC group. Similar proportions of patients had resolved or improved stenosis on follow-up imaging (NOAC: 66.7 vs. AC: 63.3%, p=0.217). Hemorrhagic complications were more likely to occur in AC compared to NOAC patients (17.0% vs. 0%, p=0.019). Conclusion: In this retrospective study, use of novel oral anticoagulants for CAD was associated with similar rates of recurrent stroke and vessel recanalization on follow-up imaging but with fewer hemorrhagic complications. Given their safety profile, NOACs may be a reasonable alternative to traditional anticoagulants in CAD. Prospective validation of these findings is needed.

Anticoagulation Regimens and Interventional Pain Procedures

2018 ◽  
Author(s):  
Christine Oryhan ◽  
Kevin Vorenkamp ◽  
Daniel Warren
Keyword(s):  
Chronic Pain ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Patient Characteristics ◽  
The United States ◽  
Bleeding Complications ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Spinal Epidural ◽  
The Ideal

With the aging population and new anticoagulant medications, such as direct oral anticoagulants, being marketed in the United States, it is very important for pain physicians to be aware of the anticoagulants available and how they affect the safety of interventional pain procedures. In addition to anticoagulant and antiplatelet medications, other medications commonly used in the chronic pain population may put patients at increased risk of bleeding complications. Certain patient characteristics, particularly in the chronic pain population, may also increase a patient’s risk of bleeding. The chapter reviews common and emerging anticoagulant and antiplatelet medications and the ideal holding time before or after interventional pain procedures, particularly in the spine. The chapter also discusses the diagnosis, treatment, and outcomes of spinal epidural hematomas.

scholarly journals Anticoagulation Use prior to Common Dental Procedures: A Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Johnny Chahine ◽  
Marwan N. Khoudary ◽  
Samer Nasr
Keyword(s):  
Systematic Review ◽  
Oral Anticoagulation ◽  
Thromboembolic Event ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Novel Oral Anticoagulants ◽  
Thromboembolic Risk ◽  
Dental Procedures ◽  
Number Of Patients

Currently, the number of patients on oral anticoagulation is increasing. There is a paucity of data regarding maintaining oral anticoagulation (especially novel oral anticoagulants) around the time of specific dental procedures. A dentist has three options: either to stop anticoagulation, to continue it, or to bridge with heparin. A systematic review of 10 clinical trials was conducted to address this issue. It was found that continuing anticoagulation during dental procedures did not increase the risk of bleeding in most trials. Although none of the studies reported a thromboembolic event after interruption of anticoagulation, the follow-up periods were short and inconsistent, and the heightened thromboembolic risk when stopping anticoagulation is well known in the literature. Heparin bridging was associated with an increased bleeding incidence. We recommend maintaining oral anticoagulation with vitamin K antagonists and novel oral anticoagulants for the vast majority of dental procedures along with the use of local hemostatic agents.

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