Periprocedural management of rivaroxaban-treated patients

被引:11
作者
Imberti, Davide [1 ]
Ambrosoli, Andrea [2 ,3 ]
Cimminiello, Claudio [4 ]
Compagnone, Christian [5 ]
Fanelli, Andrea [6 ,7 ]
Tripodi, Armando [8 ,9 ]
Ottani, Filippo [10 ]
机构
[1] Osped Piacenza, Internal Med Haemostasis & Thrombosis Ctr, Piacenza, Italy
[2] Azienda Osped Osped Circolo, Day Surg Anesthesiol, Varese, Italy
[3] Fdn Macchi, Varese, Italy
[4] Azienda Osped Desio & Vimercate, Dept Internal Med, Osped Vimercate, Vimercate, MB, Italy
[5] Univ Hosp Parma, Dept Anesthesia Intens Care & Pain Therapy, Parma, Italy
[6] St Orsola Marcello Malpighi Hosp, Dept Anesthesia, Bologna, Italy
[7] St Orsola Marcello Malpighi Hosp, Intens Care Unit, Bologna, Italy
[8] Univ Milan, Milan, Italy
[9] IRCCS Ca Granda Maggiore Hosp Fdn, Angelo Bianchi Bonomi Hemophilia & Thrombosis Ctr, Milan, Italy
[10] Osped Morgagni Pierantoni Forli, Cardiol Unit, Forli, FC, Italy
关键词
anesthesia; direct oral anticoagulants; periprocedural management; rivaroxaban; surgery; ED AMERICAN-COLLEGE; DIRECT ORAL ANTICOAGULANTS; PERIOPERATIVE MANAGEMENT; ANTITHROMBOTIC THERAPY; ATRIAL-FIBRILLATION; THROMBOSIS; METAANALYSIS; PREVENTION; WARFARIN; SURGERY;
D O I
10.1517/14656566.2015.1013939
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: The increasing and widespread use of direct oral anticoagulants (DOACs) demands guidelines and experts' consensus for their rational and safe use, especially in certain situations for which there is no evidence-based consensus, such as the periprocedural setting. Rivaroxaban is an oral factor Xa inhibitor approved for stroke prevention in atrial fibrillation (AF) and for treatment and prevention of venous thromboembolism (VTE) in major orthopedic surgery. This article is addressed to all the clinicians involved in the periprocedural approach of patients treated with rivaroxaban, with the aim to give practical recommendations to improve patients' management during and after surgery. Areas covered: This article is based on a consensus of specialists involved in anticoagulant treatment and in periprocedural setting, including experts in thrombosis, cardiologists, internists, clinical pathologists and anesthesiologists. The authors performed a review of the literature and expressed statements based on the results of the review as well as on personal experience. Expert opinion: Rivaroxaban is a safe and effective drug that simplifies management of anticoagulation also in patients undergoing invasive procedures. However, periprocedural management could be challenging and physicians must carefully balance the risk of bleeding and the risk of thrombosis.
引用
收藏
页码:685 / 691
页数:7
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