Antikoagülan ve Antitrombositik İlaç Kullanan Serebrovasküler Olay Yaşamış Hastalarda Ürolojik Operasyonların Yönetimi
Özet
Bu bölüm, antikoagülan ve antitrombositik ilaç kullanan serebrovasküler olay yaşamış hastalarda ürolojik operasyonların yönetimini ele almaktadır. Antikoagülasyon ve antitrombositik tedavisi, tromboz riskini azaltırken, cerrahi süreçlerde kanama komplikasyonlarını artırabilir. Bu nedenle, ürolojik müdahalelerin planlanmasında dikkatli bir değerlendirme gerekmektedir. Bölümde, antikoagülan ve antitrombositik tedavi alan hastalarda cerrahi öncesi, sırası ve sonrasında izlenecek stratejiler ve gerekli önlemler üzerinde durulmuştur. Bu tür hastalarda cerrahi risklerin değerlendirilmesi ve multidisipliner yaklaşımın önemi vurgulanmıştır. Sonuç olarak, uygun yönetim stratejileri ile hem tromboz hem de kanama komplikasyonlarının minimize edilebileceği sonucuna varılmıştır.
This section examines the management of urological procedures in patients with a history of cerebrovascular events who are receiving anticoagulant and antiplatelet therapies. While these interventions are effective in mitigating thrombotic risk, they may simultaneously elevate the potential for hemorrhagic complications during surgical interventions. Consequently, a meticulous evaluation is imperative in the preoperative planning of such procedures. This section delineates the strategies and necessary precautions to be implemented before, during, and after surgery for patients undergoing anticoagulation and antiplatelet therapy. It underscores the critical importance of surgical risk assessment and the adoption of a multidisciplinary approach in patient management. The conclusions drawn indicate that appropriate management strategies can significantly reduce the incidence of both thrombotic and hemorrhagic complications.
Referanslar
Campbell BCV, Khatri P. Stroke. The Lancet. 2020 Jul;396(10244):129-42
Collaborators, G.B.D.S., Global, regional and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021. 20(10): p.795-820
Roger VL, Go AS, Llyod-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics-2011 update: a report from the American Heart Association. Circulation 2011; 123: e18-e209.
GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 439-58. [Crossref]
Jørgensen ME, Torp-Pedersen C, Gislason GH, et al. Time Elapsed After Ischemic Stroke and Risk of Adverse Cardiovascular Events and Mortality Following Elective Noncardiac Surgery. JAMA. 2014;312(3):269–277. doi:10.1001/jama.2014.8165
Benesch C, Glance LG, Derdeyn CP, et al.; American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention . Perioperative neurological evaluation and management to lower the risk of acute stroke in patients undergoing noncardiac, nonneurological surgery: a scientific statement from the American Heart Association/American Stroke Association. Circulation. 2021;143(19):e923-e946. doi: 10.1161/CIR.0000000000000968
Glance LG, Benesch CG, Holloway RG, Thirukumaran CP, Nadler JW, Eaton MP, Fleming FJ, Dick AW. Association of Time Elapsed Since Ischemic Stroke With Risk of Recurrent Stroke in Older Patients Undergoing Elective Nonneurologic, Noncardiac Surgery. JAMA Surg. 2022 Aug 1;157(8):e222236. doi: 10.1001/jamasurg.2022.2236. Epub 2022 Aug 10. PMID: 35767247; PMCID: PMC9244776.
Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, Ford I, Gonzalez-Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP , Longrois D, Lüscher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Sousa-Uva M, Voudris V, Funck-Brentano C; Authors/Task Force Members:2014 ESC/ESA Guidelines on non-cardiac surgery:cardiovascular assessment and management. Eur Heart J. 2014; 35:2383-431.
Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG,Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN: 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients under-going noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Am Coll Cardiol. 2014; 64:77-137.
Schömig A, Neumann FJ, Kastrati A, Schühlen H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth EM, Richardt G, Alt E, Schmitt C, Ulm K: A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996; 334:1084-9.
Douketis, J. D., Spyropoulos, A. C., Murad, M. H., Arcelus, J. I., Dager, W. E., Dunn, A. S., ... & Moores, L. K. (2022). Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline. Chest, 162(5), e207-e243.
Douketis, J. D., Spyropoulos, A. C., Kaatz, S., Becker, R. C., Caprini, J. A., Dunn, A. S., ... & Ortel, T. L. (2015). Perioperative bridging anticoagulation in patients with atrial fibrillation. New England Journal of Medicine, 373(9), 823-833.
Douketis, J. D., Spyropoulos, A. C., Duncan, J., Carrier, M., Le Gal, G., Tafur, A. J., ... & Schulman, S. (2019). Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant. JAMA internal medicine, 179(11), 1469-1478.
Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Noncardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur J Anaesthesiol 2010;27:92-137.
Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent STsegment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2011;32:2999-3054.
Referanslar
Campbell BCV, Khatri P. Stroke. The Lancet. 2020 Jul;396(10244):129-42
Collaborators, G.B.D.S., Global, regional and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021. 20(10): p.795-820
Roger VL, Go AS, Llyod-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics-2011 update: a report from the American Heart Association. Circulation 2011; 123: e18-e209.
GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 439-58. [Crossref]
Jørgensen ME, Torp-Pedersen C, Gislason GH, et al. Time Elapsed After Ischemic Stroke and Risk of Adverse Cardiovascular Events and Mortality Following Elective Noncardiac Surgery. JAMA. 2014;312(3):269–277. doi:10.1001/jama.2014.8165
Benesch C, Glance LG, Derdeyn CP, et al.; American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention . Perioperative neurological evaluation and management to lower the risk of acute stroke in patients undergoing noncardiac, nonneurological surgery: a scientific statement from the American Heart Association/American Stroke Association. Circulation. 2021;143(19):e923-e946. doi: 10.1161/CIR.0000000000000968
Glance LG, Benesch CG, Holloway RG, Thirukumaran CP, Nadler JW, Eaton MP, Fleming FJ, Dick AW. Association of Time Elapsed Since Ischemic Stroke With Risk of Recurrent Stroke in Older Patients Undergoing Elective Nonneurologic, Noncardiac Surgery. JAMA Surg. 2022 Aug 1;157(8):e222236. doi: 10.1001/jamasurg.2022.2236. Epub 2022 Aug 10. PMID: 35767247; PMCID: PMC9244776.
Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, Ford I, Gonzalez-Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP , Longrois D, Lüscher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Sousa-Uva M, Voudris V, Funck-Brentano C; Authors/Task Force Members:2014 ESC/ESA Guidelines on non-cardiac surgery:cardiovascular assessment and management. Eur Heart J. 2014; 35:2383-431.
Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG,Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN: 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients under-going noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Am Coll Cardiol. 2014; 64:77-137.
Schömig A, Neumann FJ, Kastrati A, Schühlen H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth EM, Richardt G, Alt E, Schmitt C, Ulm K: A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996; 334:1084-9.
Douketis, J. D., Spyropoulos, A. C., Murad, M. H., Arcelus, J. I., Dager, W. E., Dunn, A. S., ... & Moores, L. K. (2022). Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline. Chest, 162(5), e207-e243.
Douketis, J. D., Spyropoulos, A. C., Kaatz, S., Becker, R. C., Caprini, J. A., Dunn, A. S., ... & Ortel, T. L. (2015). Perioperative bridging anticoagulation in patients with atrial fibrillation. New England Journal of Medicine, 373(9), 823-833.
Douketis, J. D., Spyropoulos, A. C., Duncan, J., Carrier, M., Le Gal, G., Tafur, A. J., ... & Schulman, S. (2019). Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant. JAMA internal medicine, 179(11), 1469-1478.
Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Noncardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur J Anaesthesiol 2010;27:92-137.
Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent STsegment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2011;32:2999-3054.
