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Bridge-therapy with enoxaparin in the preoperative period of endarterectomy

Jair Leopoldo Raso1, Rogério Zenóbio Darwich, Francisco de Lucca

  • 1Instituto Mineiro de Neurocirurgia, Biocor Instituto, Belo Horizonte, MG, Brazil.

Arquivos De Neuro-Psiquiatria
|November 5, 2010
PubMed

Insights

Bridge-therapy with enoxaparin effectively prevented stroke in patients undergoing endarterectomy, with a low risk of cervical clot formation. This low molecular weight heparin strategy is safe and recommended for such patients.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Cervical clot is a potential complication following endarterectomy.
  • Patients using aspirin or clopidogrel face increased risks.
  • Interrupting antiplatelet therapy before surgery can lead to stroke.

Purpose of the Study:

  • To evaluate the safety and efficacy of enoxaparin bridge-therapy.
  • To assess the risk of stroke and cervical clot formation during therapy interruption.

Main Methods:

  • Prospective study of 119 patients undergoing 124 endarterectomies.
  • Aspirin or clopidogrel was discontinued and replaced with enoxaparin preoperatively.
  • Patients were monitored for stroke and cervical clot complications.

Main Results:

  • No strokes occurred during the enoxaparin bridge-therapy period.
  • One patient (0.8%) developed a cervical clot postoperatively.
  • The mortality rate was 0.8%, with no enoxaparin-related complications.

Conclusions:

  • Bridge-therapy with enoxaparin is a safe and effective strategy for endarterectomy patients.
  • Low molecular weight heparin can mitigate stroke risk while managing antiplatelet therapy.
  • This approach minimizes perioperative complications in vascular surgery patients.

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