Featured Research

from universities, journals, and other organizations

Safe for stroke patients to continue blood thinners before minor surgical procedures

Date:
May 29, 2013
Source:
Loyola University Health System
Summary:
It is is likely safe to continue taking blood thinners before minor procedures such as dental procedures, cataract surgery or dermatologic procedures, according to a new guideline from the American Academy of Neurology.

Many patients who have experienced strokes or mini strokes take blood thinners such as aspirin or warfarin (Coumadin) to reduce the risk of blood clots that can cause strokes.

This can pose a dilemma when a patient needs to undergo a surgical procedure, because blood thinners can increase the risk of bleeding. But a new guideline from the American Academy of Neurology advises that it is likely safe to continue taking blood thinners before minor procedures such as dental procedures, cataract surgery or dermatologic procedures. The guideline is published in Neurology, the official scientific journal of the American Academy of Neurology.

"This guideline is expected to be useful to neurologists, primary care physicians, surgeons, dentists and other healthcare providers caring for these patients," said Dr. Jose Biller, chair of the Department of Neurology of Loyola University Medical Center. Dr. Biller is one of nine co-authors of the guideline; three other authors also have Loyola ties.

The physicians evaluated evidence from 133 studies. Among their findings:

  • There's a high likelihood that taking aspirin or warfarin before dental procedures will not increase the bleeding risk.
  • Aspirin is likely to not increase bleeding risk before such procedures as cataract surgery, dermatologic procedures, prostate biopsy and carpal tunnel syndrome surgery. Similarly, warfarin likely will not increase the bleeding risk in dermatologic procedures and invasive ocular anesthesia.
  • Aspirin possibly does not increase bleeding risk for such procedures as retinal surgery and ultrasound-guided biopsy.
  • Aspirin is likely to increase the bleeding risk in orthopaedic hip procedures.

The authors provide three hypothetical examples of how the guideline could be applied:

  • A 65-year-old man who had a stroke a year ago is due for routine colonoscopy screening. Given that the patient may not need to have a polyp removed during the colonoscopy -- and there's only a 2 percent chance of bleeding even if a polyp is removed -- his neurologist recommends he continue taking aspirin.
  • A 70-year-old breast cancer patient who had a previous stroke is undergoing a mastectomy. There is little research on the bleeding risk of taking aspirin before such invasive procedures. So to be safe, the neurologist and patient decide to discontinue aspirin seven days before surgery, and restart it the day after surgery.
  • A 60-year-old man who has had a stroke is undergoing cataract surgery. The neurologist reviews the guideline and finds the risks associated with warfarin during ophthalmologic procedures have not been established with sufficient precision. Nevertheless, the patient would rather face the risk of increased bleeding than risk another stroke. So the ophthalmologist, neurologist and patient decide to continue warfarin during the cataract surgery.

First author Dr. Melissa J. Armstrong began work on the guideline while she was a neurology resident at Loyola. She now is an assistant professor at the University of Maryland School of Medicine. Other guideline authors with Loyola ties are Dr. Jose Biller and Dr. Michael Schneck, professors in the Department of Neurology of Loyola University Chicago Stritch School of Medicine and Dr. Rima Dafer, a former associate professor of Neurology at Loyola who now is at NorthShore University HealthSystem.

The guideline was developed with financial support from the American Academy of Neurology. None of the authors received reimbursement, honoraria or stipends for their participation in development of the guideline.


Story Source:

The above story is based on materials provided by Loyola University Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. M. J. Armstrong, G. Gronseth, D. C. Anderson, J. Biller, B. Cucchiara, R. Dafer, L. B. Goldstein, M. Schneck, S. R. Messe. Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2013; 80 (22): 2065 DOI: 10.1212/WNL.0b013e318294b32d

Cite This Page:

Loyola University Health System. "Safe for stroke patients to continue blood thinners before minor surgical procedures." ScienceDaily. ScienceDaily, 29 May 2013. <www.sciencedaily.com/releases/2013/05/130529144321.htm>.
Loyola University Health System. (2013, May 29). Safe for stroke patients to continue blood thinners before minor surgical procedures. ScienceDaily. Retrieved September 19, 2014 from www.sciencedaily.com/releases/2013/05/130529144321.htm
Loyola University Health System. "Safe for stroke patients to continue blood thinners before minor surgical procedures." ScienceDaily. www.sciencedaily.com/releases/2013/05/130529144321.htm (accessed September 19, 2014).

Share This



More Health & Medicine News

Friday, September 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Cost of Ebola

The Cost of Ebola

Reuters - Business Video Online (Sep. 18, 2014) As Sierra Leone prepares for a three-day "lockdown" in its latest bid to stem the spread of Ebola, Ciara Lee looks at the financial implications of fighting the largest ever outbreak of the disease. Video provided by Reuters
Powered by NewsLook.com
What HealthKit Bug Means For Your iOS Fitness Apps

What HealthKit Bug Means For Your iOS Fitness Apps

Newsy (Sep. 18, 2014) Apple has delayed the launch of the HealthKit app platform, citing a bug. Video provided by Newsy
Powered by NewsLook.com
U.S. Food Makers Surpass Calorie-Cutting Pledge

U.S. Food Makers Surpass Calorie-Cutting Pledge

Newsy (Sep. 18, 2014) Sixteen large food and beverage companies in the United States that committed to cut calories in their products far surpassed their target. Video provided by Newsy
Powered by NewsLook.com
Residents Vaccinated as Haiti Fights Cholera Epidemic

Residents Vaccinated as Haiti Fights Cholera Epidemic

AFP (Sep. 18, 2014) Haitians receive the second dose of the vaccine against cholera as part of the UN's vaccination campaign. Duration: 00:34 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins