Reversal of vitamin K antagonists prior to urgent surgery

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Reversal Strategies for Vitamin K Antagonists in Acute Intracerebral Hemorrhage

OBJECTIVE There is little evidence to guide treatment strategies for intracerebral hemorrhage on vitamin K antagonists (VKA-ICH). Treatments utilized in clinical practice include fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC). Our aim was to compare case fatality with different reversal strategies. METHODS We pooled individual ICH patient data from 16 stroke registries in...

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Four-factor prothrombin complex concentrate for urgent reversal of vitamin K antagonists in patients with major bleeding.

V itamin K antagonists (VKAs), such as warfarin, are widely used for prevention and treatment of arterial and venous thrombosis. Although oral or intravenous vitamin K and fresh frozen plasma are often used to reverse the antico-agulant effects of warfarin in patients who are bleeding, this approach has important limitations. Restoration of hemosta-sis with vitamin K relies on the hepatic synth...

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Vitamin K antagonists

For the last decades, anticoagulation for stroke prevention in atrial fibrillation (AF) as well as for the prophylaxis and long-term treatment of venous thromboembolism has been entirely based on vitamin K antagonists (VKA). Although very effective under optimal conditions, long-term treatment with these drugs is flawed by the fact that the time in the therapeutic range frequently is suboptimal...

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Questionable reversal of anticoagulation in the therapeutic management of cerebral haemorrhage associated with vitamin K antagonists.

Reversal of anticoagulation is recommended to correct the international normalised ratio (INR) for patients with intracranial haemorrhage (ICH) associated with vitamin K antagonists (VKA). However, the validity of such treatment is debated. We sought to identify, prospectively, the prognostic effect of VKA-ICH treatment in a cohort of patients (n=71; median age 78 years, range 20-89; 52% males)...

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Safety of prothrombin complex concentrates for rapid anticoagulation reversal of vitamin K antagonists. A meta-analysis.

Prothrombin complex concentrates (PCCs) are recommended as the treatment of choice in warfarin-related coagulopathy. However, the risk of thromboembolic complications associated with their use is not well defined. We performed a meta-analysis to estimate the rate of thromboembolic complications in patients receiving vitamin K antagonists (VKAs) treated with PCCs for bleeding or before urgent su...

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ژورنال

عنوان ژورنال: Canadian Journal of Anesthesia/Journal canadien d'anesthésie

سال: 2010

ISSN: 0832-610X,1496-8975

DOI: 10.1007/s12630-009-9250-3