Antikoagulanzien – Grundlage, Wirkungsweise

Zusammenfassung

Das periinterventionelle Gerinnungsmanagement in der interventionellen Radiologie ist aufgrund der Vielzahl an Interventionen sowie der zur Verfügung stehenden Medikamente komplex. Es werden die Grundlagen der Blutgerinnung sowie die verschiedenen Medikamente, die sie beeinflussen können, und deren Wirkmechanismen dargestellt. Empfehlungen für die Anwendung in der klinischen Routine werden präsentiert.

Abstract

Hematologic management in patients undergoing endovascular or image-guided interventions is complex because of the different kind of procedures and wide range of therapeutics. Basic principles of coagulation and anticoagulation treatment are described. Guidelines for clinically routine work up are presented.

Keywords

Coagulation - anticoagulation treatment - interventional radiology

• Literatur

• 1 Rodgers RP, Levin J. A critical reappraisal of the bleeding time. Semin Thromb Hemost 1990; 16: 1-20
• 2 Thomas L. Labor und Diagnose. 8. . ed. TH-Books; 2012
• 3 Crockett MT, Moynagh MR, Kavanagh EC. The novel oral anticoagulants: an update for the interventional radiologist. AJR Am J Roentgenol 2012; 199: W376-379
• 4 Altenburg A, Haage P. Antiplatelet and anticoagulant drugs in interventional radiology. Cardiovasc Intervent Radiol 2012; 35: 30-42
• 5 Resnick SB, Resnick SH, Weintraub JL et al. Heparin in interventional radiology: a therapy in evolution. Semin Intervent Radiol 2005; 22: 95-107
• 6 Patel IJ, Davidson JC, Nikolic B et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23: 727-736
• 7 Horton S, Augustin S. Activated Clotting Time (ACT). Methods Mol Biol 2013; 992: 155-167
• 8 Hess CN, Becker RC, Alexander JH et al. Antithrombotic therapy in heparin-induced thrombocytopenia: guidelines translated for the clinician. J Thromb Thrombolysis 2012; 34: 552-561
• 9 Demma LJ, Winkler AM, Levy JH. A diagnosis of heparin-induced thrombocytopenia with combined clinical and laboratory methods in cardiothoracic surgical intensive care unit patients. Anesth Analg 2011; 113: 697-702
• 10 Lanzarotti S, Weigelt JA. Heparin-induced thrombocytopenia. Surg Clin North Am 2012; 92: 1559-1572
• 11 Viaro F, Dalio MB, Evora PR. Catastrophic cardiovascular adverse reactions to protamine are nitric oxide/cyclic guanosine monophosphate dependent and endothelium mediated: should methylene blue be the treatment of choice?. Chest 2002; 122: 1061-1066
• 12 Choo JK, Kereiakes DJ. Low molecular weight heparin therapy for percutaneous coronary intervention: a practice in evolution. J Thromb Thrombolysis 2001; 11: 235-246
• 13 Greinacher A, Janssens U, Berg G et al. Lepirudin (recombinant hirudin) for parenteral anticoagulation in patients with heparin-induced thrombocytopenia. Heparin-Associated Thrombocytopenia Study (HAT) investigators. Circulation 1999; 100: 587-593
• 14 Sinauridze EI, Panteleev MA, Ataullakhanov FI. Anticoagulant therapy: basic principles, classic approaches and recent developments. Blood Coagul Fibrinolysis 2012; 23: 482-493
• 15 Schomig A, Neumann FJ, Kastrati A et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 1996; 334: 1084-1089
• 16 Lyden SP, Smouse HB. TASC II and the endovascular management of infrainguinal disease. J Endovasc Ther 2009; 16: II5-18
• 17 Norgren L, Hiatt WR, Dormandy JA et al. Inter-society consensus for the management of peripheral arterial disease. Int Angiol 2007; 26: 81-157
• 18 Sacks D, McClenny TE, Cardella JF et al. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 2003; 14: 199-202
• 19 Schuijt MP, Huntjens-Fleuren HW, de Metz M et al. The interaction of ibuprofen and diclofenac with aspirin in healthy volunteers. Br J Pharmacol 2009; 157: 931-934
• 20 Collaboration AT. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71-86
• 21 Schaefer OP, Gore JM. Aspirin sensitivity: the role for aspirin challenge and desensitization in postmyocardial infarction patients. Cardiology 1999; 91: 8-13
• 22 Schuhlen H, Kastrati A, Pache J et al. Sustained benefit over four years from an initial combined antiplatelet regimen after coronary stent placement in the ISAR trial. Intracoronary Stenting and Antithrombotic Regimen. Am J Cardiol 2001; 87: 397-400
• 23 Coller BS. Blockade of platelet GPIIb/IIIa receptors as an antithrombotic strategy. Circulation 1995; 92: 2373-2380
• 24 Stangl PA, Lewis S. Review of Currently Available GP IIb/IIIa Inhibitors and Their Role in Peripheral Vascular Interventions. Semin Intervent Radiol 2010; 27: 412-421
• 25 Popma JJ, Ohman EM, Weitz J et al. Antithrombotic therapy in patients undergoing percutaneous coronary intervention. Chest 2001; 119: 321S-336S
• 26 Easton JD. Clinical aspects of the use of clopidogrel, a new antiplatelet agent. Semin Thromb Hemost 1999; 25: 77-82
• 27 Gurbel PA, Bliden KP, Hayes KM et al. The relation of dosing to clopidogrel responsiveness and the incidence of high post-treatment platelet aggregation in patients undergoing coronary stenting. J Am Coll Cardiol 2005; 45: 1392-1396
• 28 Klisch J, Turk A, Turner R et al. Very late thrombosis of flow-diverting constructs after the treatment of large fusiform posterior circulation aneurysms. AJNR Am J Neuroradiol 2011; 32: 627-632
• 29 Oxley TJ, Dowling RJ, Mitchell PJ et al. Antiplatelet resistance and thromboembolic complications in neurointerventional procedures. Front Neurol 2011; 2: 83
• 30 Gold HK, Garabedian HD, Dinsmore RE et al. Restoration of coronary flow in myocardial infarction by intravenous chimeric 7E3 antibody without exogenous plasminogen activators. Observations in animals and humans. Circulation 1997; 95: 1755-1759
• 31 Smith Jr SC, Feldman TE et al. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol 2006; 47: 216-235
• 32 Gralla J, Rennie AT, Corkill RA et al. Abciximab for thrombolysis during intracranial aneurysm coiling. Neuroradiology 2008; 50: 1041-1047
• 33 Taqi MA, Vora N, Callison RC et al. Past, present, and future of endovascular stroke therapies. Neurology 2012; 79 (13) 213-220
• 34 Braithwaite BD, Buckenham TM, Galland RB et al. Prospective randomized trial of high-dose bolus versus low-dose tissue plasminogen activator infusion in the management of acute limb ischaemia. Thrombolysis Study Group. Br J Surg 1997; 84: 646-650
• 35 Hacke W, Kaste M, Fieschi C et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet 1998; 352: 1245-1251
• 36 Jadhav AP, Jovin TG. Intra-arterial reperfusion strategies in acute ischemic stroke. J Neurointerv Surg 2013; 5 : i66-i69
• 37 Darcy MD, Kanterman RY, Kleinhoffer MA et al. Evaluation of coagulation tests as predictors of angiographic bleeding complications. Radiology 1996; 198: 741-744
• 38 Abdihalim MM, Hassan AE, Qureshi AI. Off-Label Use of Drugs and Devices in the Neuroendovascular Suite. AJNR Am J Neuroradiol 2013;
• 39 Chew DP, Bhatt DL, Lincoff AM et al. Defining the optimal activated clotting time during percutaneous coronary intervention: aggregate results from 6 randomized, controlled trials. Circulation 2001; 103: 961-966
• 40 Tie ML, Koczwara B. Radiology interventions in patients receiving low molecular weight heparin: timing is critical. Australas Radiol 2001; 45: 313-317
• 41 Vavricka SR, Walter RB, Irani S et al. Safety of lumbar puncture for adults with acute leukemia and restrictive prophylactic platelet transfusion. Ann Hematol 2003; 82: 570-573