• Am J Ther · Jul 2011

    Review

    Periprocedural bridging anticoagulation: current perspectives.

    • Chandrasekar Palaniswamy and Dhana R Selvaraj.
    • Department of Medicine, New York Medical College, Valhalla, NY 10595, USA. drpchandrasekar@gmail.com
    • Am J Ther. 2011 Jul 1;18(4):e89-94.

    AbstractPerioperative management of patients on chronic anticoagulant use involves balancing individual risk for thromboembolism and bleeding. Discontinuation of antithrombotic therapy can place patients at increased risk of thromboembolic complications, whereas continuing antithrombotic therapy can increase procedure-related bleeding risk. Temporary perioperative substitution of low-molecular weight heparin or unfractionated heparin in place of warfarin, "the bridge therapy" is often used in the periprocedural period, but the indications and timing of this is still uncertain. This review addresses the risk stratification of patients according to thromboembolic risk, indications, timing, and duration, and a practical approach to bridge therapy.

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