Stopping aspirin before surgery guidelines
How to prevent a stroke with dr. richard green
Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Cleveland, OH. Anbazhagan Prabhakaran Department of Hospital Medicine, Cleveland Clinic; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Cleveland, OH. Christopher Whinney is the chairman of the Cleveland Clinic’s Department of Hospital Medicine and a clinical assistant professor at Case Western Reserve University’s Lerner College of Medicine.
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Anticoagulation after acute stroke – when/ how to start
After a stroke, myocardial infarction (MI), myocardial revascularization, or a diagnosis of peripheral arterial disease or acute coronary syndrome, long-term antiplatelet therapy is an important part of secondary prevention. Following percutaneous coronary intervention with bare-metal or drug-eluting stent placement, dual antiplatelet treatment (aspirin and clopidogrel [Plavix]) prevents stent thrombosis. Antiplatelet agents are indicated in the perioperative period because of elevated platelet activity following surgery; however, they also raise the risk of surgical bleeding. The main question is whether the risk of hemorrhage with antiplatelet therapy is lower than the risk of thrombosis when antiplatelet agents are stopped. Tap to enlarge
American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Rhythm Society; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Assessment for Noncardiac Surgery); American Society of Echocardiography; American Society of Nuclear Cardiology; American Society of Nuclear Cardiology; American Society of Nuclear Cardiology; American Society of Nuclear
A patient, who had an angioplasty done a year back now
Q. I’ve heard that if you take aspirin every day, avoiding it for a short period of time raises the chances of getting a heart attack even more than if you hadn’t taken aspirin at all. Is that correct? Is there a better way than stopping aspirin cold turkey if I need to stop taking it for some reason?
A. The rebound effect, also known as the rebound phenomenon, is what you’re describing. It happens when a person begins taking a medication and the symptoms or condition that the medication had previously managed reappear, but in a more serious form than before the person began taking the medication. While some beta blockers and sedatives used to treat insomnia have been known to cause a rebound effect, this is unlikely to happen with aspirin.
Lower endoscopy – lower gi – colonoscopy procedure
In the long-term treatment of heart, cerebrovascular, and peripheral vascular disorders, a growing number of potent antiplatelet and anticoagulant drugs are being used. For physicians, managing these drugs in the perioperative and peri-injury settings may be difficult, necessitating a thorough understanding of these medications as well as the risks and benefits of different treatment strategies. Agents frequently encountered by surgeons in the perioperative and peri-injury settings are discussed in this two-part study, as are treatment techniques for patients on long-term antiplatelet and anticoagulant therapy. The first section of this article addresses warfarin and the current direct oral anticoagulants. In part two, we look at antiplatelet agents, platelet function testing, and long-term anticoagulation and antiplatelet therapy perioperative treatment. This is an Open Access article distributed under the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which allows anyone to share, remix, adapt, and expand upon this work for non-commercial purposes, and to license their derivative works under different terms, as long as the original work is properly referenced and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/ for more information.