Download PDF
Phlebologie 2022; 51(01): 37-50
DOI: 10.1055/a-1679-0677
CME-Fortbildung

Bridging unter Antikoagulation und Thrombozytenaggregationshemmung

Bridging under anticoagulation and antiplatelet therapy
Ertunc Altiok
,
Mohammad Almalla
› Further Information
Also available at
   Permissions and Reprints

Abtract

When bridging anticoagulation, the risk of bleeding - compared to the thromboembolic risk - is often underestimated. Bridging is only indicated in case of high (and possibly moderate) thromboembolic risk. When bridging patients with indication for dual antiplatelet therapy, an interdisciplinary case discussion should take place to assess the risk.

Beim Bridging einer Antikoagulation wird das Blutungsrisiko – im Vergleich zum thromboembolischen Risiko – oft unterschätzt. Das Bridging ist nur bei einem hohen (und evtl. bei einem moderaten) thromboembolischen Risiko angezeigt. Beim Bridging von Patienten mit der Indikation zur dualen Thrombozytenaggregationshemmung sollte eine interdisziplinäre Fallbesprechung zur Risikoabschätzung stattfinden.

Schlüsselwörter

Bridging - Antikoagulation - Vitamin-K-Antagonisten - nicht Vitamin-K-abhängige orale Antikoagulanzien

Keywords

Bridging - anticoagulation - vitamin k antagonists - non-vitamin K-dependent oral anticoagulants


Publication History

Article published online:
10 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Rechenmacher SJ, Fang JC. Bridging Anticoagulation: Primum Non Nocere. J Am Coll Cardiol 2015; 66: 1392-1403
    CrossrefPubMedSearch in Google Scholar
  • 2 Lange CM, Fichtlscherer S, Miesbach W. et al. The Periprocedural Management of Anticoagulation and Platelet Aggregation Inhibitors in Endoscopic Interventions. Dtsch Arztebl Int 2016; 113: 129-135
    CrossrefPubMedSearch in Google Scholar
  • 3 Douketis JD, Spyropoulos AC, Kaatz S. et al. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med 2015; 373: 823-833
    CrossrefPubMedSearch in Google Scholar
  • 4 Birnie DH, Healey JS, Wells GA. et al. Pacemaker or defibrillator surgery without interruption of anticoagulation. N Engl J Med 2013; 368: 2084-2093
    CrossrefPubMedSearch in Google Scholar
  • 5 Bajkin BV, Popovic SL, Selakovic SD. Randomized, prospective trial comparing bridging therapy using low-molecular-weight heparin with maintenance of oral anticoagulation during extraction of teeth. J Oral Maxillofac Surg 2009; 67: 990-995
    CrossrefPubMedSearch in Google Scholar
  • 6 Schlitt A, Jambor C, Spannagl M. et al. The perioperative management of treatment with anticoagulants and platelet aggregation inhibitors. Dtsch Arztebl Int 2013; 110: 525-532
    CrossrefPubMedSearch in Google Scholar
  • 7 Rossini R, Musumeci G, Visconti LO. et al. Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies. EuroIntervention 2014; 10: 38-46
    CrossrefPubMedSearch in Google Scholar
  • 8 Kristensen SD, Knuuti J, Saraste A. et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 2014; 35: 2383-2431
    CrossrefPubMedSearch in Google Scholar
  • 9 Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med 2013; 368: 2113-2124
    CrossrefPubMedSearch in Google Scholar
  • 10 Heidbuchel H, Verhamme P, Alings M. et al. Updated European Heart Rhythm Association practical guide on the use of nonvitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary. Eur Heart J 2017; 38: 2137-2149
    CrossrefPubMedSearch in Google Scholar
  • 11 Qamar A, Vaduganathan M, Greenberger NJ. et al. Oral Anticoagulation in Patients With Liver Disease. J Am Coll Cardiol 2018; 71: 2162-2175
    CrossrefPubMedSearch in Google Scholar
  • 12 Pollack CV jr., Reilly PA, van Ryn J. et al. Idarucizumab for Dabigatran Reversal – Full Cohort Analysis. N Engl J Med 2017; 377: 431-441
    CrossrefPubMedSearch in Google Scholar
  • 13 Connolly SJ, Crowther M, Eikelboom JW. et al. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. N Engl J Med 2019; 380: 1326-1335
    CrossrefPubMedSearch in Google Scholar
  • 14 Baumgartner H, Falk V, Bax JJ. et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2017; 38: 2739-2791
    CrossrefPubMedSearch in Google Scholar
  • 15 Valgimigli M, Bueno H, Byrne RA. et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39: 213-260
    CrossrefPubMedSearch in Google Scholar