Da nicht-Vitamin-K-antagonisierende orale Antikoagulanzien (NOAKs) immer häufiger verordnet werden und sich antikoagulierte Patienten oft einer Intervention unterziehen müssen, ist eine umfassende Kenntnis über den adäquaten peri-interventionellen Umgang mit diesen Substanzen erforderlich. Für Elektiv- und Notfallsituationen muss ein standardisiertes Vorgehen geplant werden. Infolge ihrer Pharmakokinetik ist das peri-interventionelle endoskopische Management der NOAKs vergleichsweise einfach. Ein Heparin-„Bridging“/“Switching“ ist in der Regel nicht erforderlich. Bei schweren Blutungen unter NOAKs muss frühzeitig eine Endoskopie in Betracht gezogen werden.
Abstract
Anti-coagulated patients often undergo endoscopic procedures and non-vitamin-K-antagonist oral anticoagulants (NOAC) are increasingly prescribed. Consequently, a comprehensive knowledge about the adequate peri-interventional handling of these substances is required. A standardized approach needs to be planned for elective and emergency situations. As a result of their pharmacokinetics, the peri-endoscopic management of NOAC is relatively easy – an heparin “bridging”/”switching” is usually not required. In case of a severe NOAC bleeding endoscopic treatment must be considered at an early stage.
Schlüsselwörter
NOAK -
peri-endoskopisches Management
Keywords
NOAC -
peri-endoscopic management
Literatur
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