You'll have to have your doctor get the full article to make sure s/he is up-to-date on your anticoagulation needs.
Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients
Abstract
Objective: To assess
evidence regarding periprocedural management of antithrombotic drugs in
patients with ischemic cerebrovascular
disease. The complete guideline on which this
summary is based is available as an online data supplement to this
article.
Methods: Systematic literature review with practice recommendations.
Results and recommendations:
Clinicians managing antithrombotic medications periprocedurally must
weigh bleeding risks from drug continuation against
thromboembolic risks from discontinuation.
Stroke patients undergoing dental procedures should routinely continue
aspirin
(Level A). Stroke patients undergoing invasive
ocular anesthesia, cataract surgery, dermatologic procedures,
transrectal ultrasound–guided
prostate biopsy, spinal/epidural procedures, and
carpal tunnel surgery should probably continue aspirin (Level B). Some
stroke
patients undergoing vitreoretinal surgery, EMG,
transbronchial lung biopsy, colonoscopic polypectomy, upper endoscopy
and
biopsy/sphincterotomy, and abdominal
ultrasound–guided biopsies should possibly continue aspirin (Level C).
Stroke patients
requiring warfarin should routinely continue it
when undergoing dental procedures (Level A) and probably continue it for
dermatologic
procedures (Level B). Some patients undergoing
EMG, prostate procedures, inguinal herniorrhaphy, and endothermal
ablation
of the great saphenous vein should possibly
continue warfarin (Level C). Whereas neurologists should counsel that
warfarin
probably does not increase clinically important
bleeding with ocular anesthesia (Level B), other ophthalmologic studies
lack
the statistical precision to make
recommendations (Level U). Neurologists should counsel that warfarin
might increase bleeding
with colonoscopic polypectomy (Level C). There
is insufficient evidence to support or refute periprocedural heparin
bridging
therapy to reduce thromboembolic events in
chronically anticoagulated patients (Level U). Neurologists should
counsel that
bridging therapy is probably associated with
increased bleeding risks as compared with warfarin cessation (Level B).
The risk
difference as compared with continuing warfarin
is unknown (Level U).
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