Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Perioperative Management of New Oral Anticoagulants in Urological Surgery

Perioperative Management of New Oral Anticoagulants in Urological Surgery New oral anticoagulants (NOACs) are increasingly replacing the use of warfarin in clinical practice. Their use has now also been extended to thromboprophylaxis in many orthopedic surgeries. This, in addition to an increasingly aging population with many complex comorbidities means that these medications will be ever more frequently encountered by urologists. Thus, a clear understanding of the mechanism of action of NOACs, their time to peak action and half-life is essential for the purpose of managing these patients perioperatively. This article demonstrates the patient and procedural variability that must be taken into account in the perioperative management of the anticoagulated patient. While the time to peak onset and half-life of NOACs can aid in determining the interval of interruption of anticoagulation, the risks of thrombosis and bleeding must be assessed before the decision to stop anticoagulation. This article takes into account the evidence available on NOACs in urological surgery in order to inform the perioperative management of these medications and to propose guidelines to aid in clinical decision making. In attempting this, we address the issue of the lack of high-level evidence surrounding NOACs in urological surgery given their relative novelty and the need for further research to better guide practice. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Perioperative Management of New Oral Anticoagulants in Urological Surgery

Download PDF
6 pages

Loading next page...
 
/lp/karger/perioperative-management-of-new-oral-anticoagulants-in-urological-2PYDN42dtQ

References (12)

Publisher
Karger
Copyright
© 2017 S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000447214
Publisher site
See Article on Publisher Site

Abstract

New oral anticoagulants (NOACs) are increasingly replacing the use of warfarin in clinical practice. Their use has now also been extended to thromboprophylaxis in many orthopedic surgeries. This, in addition to an increasingly aging population with many complex comorbidities means that these medications will be ever more frequently encountered by urologists. Thus, a clear understanding of the mechanism of action of NOACs, their time to peak action and half-life is essential for the purpose of managing these patients perioperatively. This article demonstrates the patient and procedural variability that must be taken into account in the perioperative management of the anticoagulated patient. While the time to peak onset and half-life of NOACs can aid in determining the interval of interruption of anticoagulation, the risks of thrombosis and bleeding must be assessed before the decision to stop anticoagulation. This article takes into account the evidence available on NOACs in urological surgery in order to inform the perioperative management of these medications and to propose guidelines to aid in clinical decision making. In attempting this, we address the issue of the lack of high-level evidence surrounding NOACs in urological surgery given their relative novelty and the need for further research to better guide practice.

Journal

Current Urology – Karger

Published: Jan 1, 2018

Keywords: Novel oral anticoagulant; Anticoagulation; Urology

There are no references for this article.