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Article: Perioperative antithrombotic management in joint replacement surgeries

TitlePerioperative antithrombotic management in joint replacement surgeries
Authors
Issue Date2013
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
Hong Kong Medical Journal, 2013, v. 19 n. 6, p. 531-538 How to Cite?
AbstractObjectives To determine optimal perioperative antithrombotic management for patients with cardiac diseases undergoing joint replacement surgeries. Data sources MEDLINE and PubMed database search up to January 2013. Study selection Those dealing with perioperative antithrombotic management of patients undergoing orthopaedic operations, especially joint replacement, and also those undergoing general surgery. Various combinations of the following key words were used in our search: 'antiplatelet', 'antithrombotic', 'anticoagulant', 'coronary stent', 'perioperative', 'venous thromboembolism', 'cardiovascular', 'surgery', 'orthopaedic', 'knee replacement', 'hip replacement', 'joint replacement', and 'arthroplasty'. Data extraction Literature review, original articles, and best practice guidelines. Data synthesis Patients should be stratified according to their risk of developing arterial thromboembolism in order to decide the most appropriate perioperative antiplatelet or anticoagulant regimen for them. After recent coronary stenting, including bare-metal stents implanted within 6 weeks and drug-eluting stents implanted within 6 months, surgery should be deferred. For venous thromboembolism prophylaxis in patients already on aspirin, the dosage should be adjusted as necessary or additional low-molecular-weight heparin administered. Conclusion The perioperative management of patients with cardiac diseases in receipt of antithrombotic agents is based upon a delicate balance between the perceived risk of arterial thromboembolism and the perceived risk of perioperative bleeding. One must exercise good judgement in deciding the most appropriate perioperative antithrombotic regimen. Venous thromboembolism is also a common problem after joint replacement surgeries. For patients already on aspirin, optimal venous thromboembolism prophylaxis is still being debated.
Persistent Identifierhttp://hdl.handle.net/10722/194966
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorLee, HLR-
dc.contributor.authorChiu, PKY-
dc.contributor.authorYiu, KH-
dc.contributor.authorNg, FY-
dc.contributor.authorYan, CH-
dc.contributor.authorChan, PK-
dc.date.accessioned2014-02-21T06:41:15Z-
dc.date.available2014-02-21T06:41:15Z-
dc.date.issued2013-
dc.identifier.citationHong Kong Medical Journal, 2013, v. 19 n. 6, p. 531-538-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/194966-
dc.description.abstractObjectives To determine optimal perioperative antithrombotic management for patients with cardiac diseases undergoing joint replacement surgeries. Data sources MEDLINE and PubMed database search up to January 2013. Study selection Those dealing with perioperative antithrombotic management of patients undergoing orthopaedic operations, especially joint replacement, and also those undergoing general surgery. Various combinations of the following key words were used in our search: 'antiplatelet', 'antithrombotic', 'anticoagulant', 'coronary stent', 'perioperative', 'venous thromboembolism', 'cardiovascular', 'surgery', 'orthopaedic', 'knee replacement', 'hip replacement', 'joint replacement', and 'arthroplasty'. Data extraction Literature review, original articles, and best practice guidelines. Data synthesis Patients should be stratified according to their risk of developing arterial thromboembolism in order to decide the most appropriate perioperative antiplatelet or anticoagulant regimen for them. After recent coronary stenting, including bare-metal stents implanted within 6 weeks and drug-eluting stents implanted within 6 months, surgery should be deferred. For venous thromboembolism prophylaxis in patients already on aspirin, the dosage should be adjusted as necessary or additional low-molecular-weight heparin administered. Conclusion The perioperative management of patients with cardiac diseases in receipt of antithrombotic agents is based upon a delicate balance between the perceived risk of arterial thromboembolism and the perceived risk of perioperative bleeding. One must exercise good judgement in deciding the most appropriate perioperative antithrombotic regimen. Venous thromboembolism is also a common problem after joint replacement surgeries. For patients already on aspirin, optimal venous thromboembolism prophylaxis is still being debated.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titlePerioperative antithrombotic management in joint replacement surgeries-
dc.typeArticle-
dc.identifier.emailLee, HLR: ricklhl@gmail.com-
dc.identifier.emailChiu, PKY: pkychiu@hkucc.hku.hk-
dc.identifier.emailYiu, KH: khkyiu@hku.hk-
dc.identifier.emailNg, FY: fyng@hkucc.hku.hk-
dc.identifier.emailYan, CH: yanchoi@hku.hk-
dc.identifier.emailChan, PK: cpk464@hku.hk-
dc.identifier.authorityChiu, PKY=rp00379-
dc.identifier.authorityYiu, KH=rp01490-
dc.identifier.authorityYan, CH=rp00303-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.12809/hkmj134073-
dc.identifier.pmid24141860-
dc.identifier.scopuseid_2-s2.0-84889677828-
dc.identifier.hkuros228091-
dc.identifier.volume19-
dc.identifier.issue6-
dc.identifier.spage531-
dc.identifier.epage538-
dc.publisher.placeHong Kong-

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