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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
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Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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[How to Avoid Periprocedural Thrombotic Complications].

Yukiko Enomoto1

  • 1Department of Neurosurgery, Gifu University Hospital.

No Shinkei Geka. Neurological Surgery
|January 25, 2021
PubMed
Summary

Dual antiplatelet therapy is standard in neuroendovascular procedures to prevent clots. However, it increases bleeding risks and doesn't prevent stroke recurrence, necessitating careful patient management.

Area of Science:

  • Neurology
  • Cardiology
  • Vascular Surgery

Background:

  • Antithrombotic agents are crucial in neuroendovascular therapy to prevent thromboembolic events.
  • Both anticoagulants and antiplatelets are necessary to prevent different types of thrombi (red and white).
  • Aggressive periprocedural antiplatelet therapy, including dual antiplatelet therapy (DAPT), is increasingly used with advanced endovascular techniques.

Purpose of the Study:

  • To evaluate the role and risks of antithrombotic agents, particularly DAPT, in neuroendovascular therapy.
  • To discuss the balance between preventing ischemic complications and managing hemorrhagic risks.
  • To provide guidance on adjusting antithrombotic therapy based on individual patient risk.

Main Methods:

  • Review of current literature and clinical practices regarding antithrombotic therapy in neuroendovascular procedures.

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  • Analysis of the efficacy of anticoagulants and antiplatelets in preventing periprocedural complications.
  • Assessment of the risks associated with DAPT, including ischemic and hemorrhagic events.

    • Main Results:

    • DAPT is the current standard for many neuroendovascular treatments.
    • While perioperative antithrombotic therapy can reduce ischemic complications, it elevates the risk of bleeding.
    • Long-term DAPT does not improve stroke recurrence rates and is linked to increased major bleeding.

    Conclusions:

    • Careful consideration of antithrombotic therapy is essential in neuroendovascular procedures.
    • The benefits of DAPT must be weighed against the increased risk of hemorrhagic complications.
    • For high-risk patients, dose reduction or early discontinuation of antithrombotic therapy may be warranted.