Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Endoscopic Sinus Surgery (ESS) has not been studied in patients receiving anticoagulant or antiplatelet therapy. Classifing this procedure into a bleeding risk category needs to be done to safely manage these therapies perioperatively. Methods: Design: Retrospective case control study of prospectively collected data. Setting: Academic tertiary referral center. Patients: 42 patients receiving anticoagulant therapy who underwent an endoscopic sinus surgery between October 1997 and December 2005, compared to a control group of 42 patients matched for age and gender. Results: The mean estimated blood loss (EBL) during surgery was slightly higher for the control group without reaching a statistically significant difference (p = 0.14). EBL was significantly higher when more sinuses were opened during surgery (p = 0.001). There was no reported major postoperative bleeding related to anticoagulation. All patients were able to resume their anticoagulation or antiplatelet therapy after the surgery. Conclusion: ESS is a safe procedure when performed in patients receiving anticoagulation or antiplatet therapy, and could be classified as a moderate bleeding risk surgery. Stopping the medication prior to the surgery is mandatory. However, anticoagulation could be resumed early postoperatively because it does not seen to increase the risk for bleeding. Perioperative bridging with heparin should only be dictated by the patient's condition, not by the procedure itself.

Original languageEnglish
Pages (from-to)335-338
Number of pages4
JournalAmerican Journal of Rhinology
Volume21
Issue number3
DOIs
StatePublished - May 1 2007

Fingerprint

Anticoagulants
Hemorrhage
Therapeutics
Control Groups
Tertiary Care Centers
Heparin
Case-Control Studies

Keywords

  • Anticoagulation
  • Antiplatelet therapy
  • Aspirin
  • Bleeding risk
  • Clopidogrel
  • Complications
  • Endoscopic sinus surgery
  • Outcomes
  • Ticlopidine
  • Warfarin

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy. / Sargi, Zoukaa B; Casiano, Roy R.

In: American Journal of Rhinology, Vol. 21, No. 3, 01.05.2007, p. 335-338.

Research output: Contribution to journalArticle

@article{4beb087a2c0442039bb49fd6ae3c7b5f,
title = "Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy",
abstract = "Background: Endoscopic Sinus Surgery (ESS) has not been studied in patients receiving anticoagulant or antiplatelet therapy. Classifing this procedure into a bleeding risk category needs to be done to safely manage these therapies perioperatively. Methods: Design: Retrospective case control study of prospectively collected data. Setting: Academic tertiary referral center. Patients: 42 patients receiving anticoagulant therapy who underwent an endoscopic sinus surgery between October 1997 and December 2005, compared to a control group of 42 patients matched for age and gender. Results: The mean estimated blood loss (EBL) during surgery was slightly higher for the control group without reaching a statistically significant difference (p = 0.14). EBL was significantly higher when more sinuses were opened during surgery (p = 0.001). There was no reported major postoperative bleeding related to anticoagulation. All patients were able to resume their anticoagulation or antiplatelet therapy after the surgery. Conclusion: ESS is a safe procedure when performed in patients receiving anticoagulation or antiplatet therapy, and could be classified as a moderate bleeding risk surgery. Stopping the medication prior to the surgery is mandatory. However, anticoagulation could be resumed early postoperatively because it does not seen to increase the risk for bleeding. Perioperative bridging with heparin should only be dictated by the patient's condition, not by the procedure itself.",
keywords = "Anticoagulation, Antiplatelet therapy, Aspirin, Bleeding risk, Clopidogrel, Complications, Endoscopic sinus surgery, Outcomes, Ticlopidine, Warfarin",
author = "Sargi, {Zoukaa B} and Casiano, {Roy R}",
year = "2007",
month = "5",
day = "1",
doi = "10.2500/ajr.2007.21.3019",
language = "English",
volume = "21",
pages = "335--338",
journal = "American Journal of Rhinology and Allergy",
issn = "1945-8924",
publisher = "OceanSide Publications Inc.",
number = "3",

}

TY - JOUR

T1 - Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy

AU - Sargi, Zoukaa B

AU - Casiano, Roy R

PY - 2007/5/1

Y1 - 2007/5/1

N2 - Background: Endoscopic Sinus Surgery (ESS) has not been studied in patients receiving anticoagulant or antiplatelet therapy. Classifing this procedure into a bleeding risk category needs to be done to safely manage these therapies perioperatively. Methods: Design: Retrospective case control study of prospectively collected data. Setting: Academic tertiary referral center. Patients: 42 patients receiving anticoagulant therapy who underwent an endoscopic sinus surgery between October 1997 and December 2005, compared to a control group of 42 patients matched for age and gender. Results: The mean estimated blood loss (EBL) during surgery was slightly higher for the control group without reaching a statistically significant difference (p = 0.14). EBL was significantly higher when more sinuses were opened during surgery (p = 0.001). There was no reported major postoperative bleeding related to anticoagulation. All patients were able to resume their anticoagulation or antiplatelet therapy after the surgery. Conclusion: ESS is a safe procedure when performed in patients receiving anticoagulation or antiplatet therapy, and could be classified as a moderate bleeding risk surgery. Stopping the medication prior to the surgery is mandatory. However, anticoagulation could be resumed early postoperatively because it does not seen to increase the risk for bleeding. Perioperative bridging with heparin should only be dictated by the patient's condition, not by the procedure itself.

AB - Background: Endoscopic Sinus Surgery (ESS) has not been studied in patients receiving anticoagulant or antiplatelet therapy. Classifing this procedure into a bleeding risk category needs to be done to safely manage these therapies perioperatively. Methods: Design: Retrospective case control study of prospectively collected data. Setting: Academic tertiary referral center. Patients: 42 patients receiving anticoagulant therapy who underwent an endoscopic sinus surgery between October 1997 and December 2005, compared to a control group of 42 patients matched for age and gender. Results: The mean estimated blood loss (EBL) during surgery was slightly higher for the control group without reaching a statistically significant difference (p = 0.14). EBL was significantly higher when more sinuses were opened during surgery (p = 0.001). There was no reported major postoperative bleeding related to anticoagulation. All patients were able to resume their anticoagulation or antiplatelet therapy after the surgery. Conclusion: ESS is a safe procedure when performed in patients receiving anticoagulation or antiplatet therapy, and could be classified as a moderate bleeding risk surgery. Stopping the medication prior to the surgery is mandatory. However, anticoagulation could be resumed early postoperatively because it does not seen to increase the risk for bleeding. Perioperative bridging with heparin should only be dictated by the patient's condition, not by the procedure itself.

KW - Anticoagulation

KW - Antiplatelet therapy

KW - Aspirin

KW - Bleeding risk

KW - Clopidogrel

KW - Complications

KW - Endoscopic sinus surgery

KW - Outcomes

KW - Ticlopidine

KW - Warfarin

UR - http://www.scopus.com/inward/record.url?scp=34250890798&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250890798&partnerID=8YFLogxK

U2 - 10.2500/ajr.2007.21.3019

DO - 10.2500/ajr.2007.21.3019

M3 - Article

C2 - 17621820

AN - SCOPUS:34250890798

VL - 21

SP - 335

EP - 338

JO - American Journal of Rhinology and Allergy

JF - American Journal of Rhinology and Allergy

SN - 1945-8924

IS - 3

ER -