Risk of bleeding associated with interventional musculoskeletal radiology procedures. A comprehensive review of the literature

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9 Citations (Scopus)

Abstract

This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient’s particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures.

Original languageEnglish (US)
Pages (from-to)619-627
Number of pages9
JournalSkeletal Radiology
Volume44
Issue number5
DOIs
StatePublished - 2015

Fingerprint

Interventional Radiology
Hemorrhage
Therapeutics
International Normalized Ratio
Needle Biopsy
Tendons
Anticoagulants
Decision Making
Bone and Bones
Muscles
Injections

Keywords

  • Anticoagulation
  • Arthrocentesis
  • Arthrogram
  • Biopsy
  • Bleeding risk
  • Bone marrow biopsy
  • Joint injection
  • Musculoskeletal intervention
  • Peritendinous injection
  • Warfarin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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abstract = "This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient’s particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures.",
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