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Continuing aspirin therapy during percutaneous nephrolithotomy: unsafe or under-utilized?
David A Leavitt1, Nithin Theckumparampil, Daniel M Moreira
1The Smith Institute for Urology , Hofstra North Shore Long Island Jewish School of Medicine, New Hyde Park, New York.
Journal of Endourology
|November 14, 2014
Summary
Continuing aspirin during percutaneous nephrolithotomy (PCNL) is safe. This study found no increased complications or blood transfusions in patients who continued aspirin versus those who stopped it before surgery.
Area of Science:
- Nephrology
- Urology
- Cardiology
Background:
- Traditionally, aspirin is stopped before percutaneous nephrolithotomy (PCNL) due to hemorrhage concerns.
- Evidence suggests discontinuing aspirin may pose greater risks than continuing it.
Purpose of the Study:
- To compare PCNL outcomes and complications in patients continuing aspirin versus those stopping it.
- To evaluate the safety of perioperative aspirin use in PCNL patients.
Main Methods:
- Retrospective review of 321 PCNL procedures.
- Patients divided into two groups: continuing aspirin (on-aspirin) and temporarily stopping aspirin (off-aspirin).
- Comparison of surgical outcomes and complications between the two groups.
Main Results:
- No significant differences observed in operative time, hemoglobin change, stone size, stone-free rate, or length of hospitalization.
- Transfusion rates and total complications were similar between the on-aspirin and off-aspirin groups.
- No thromboembolic events occurred in any patient.
Conclusions:
- Percutaneous nephrolithotomy (PCNL) is safe for patients continuing aspirin perioperatively.
- Continuing aspirin does not increase blood transfusions, angioembolization, or complications.
- Patients at high risk for thromboembolic events can safely undergo PCNL without aspirin discontinuation.
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