Friday, 08 December 2017 18:44

Anticoagulation news items. Week commencing 4th December 2017

Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis

New England Journal of Medicine

RCT (n-692) found that between 6 and 24 months, addition of catheter-directed thrombolysis to anticoagulation did not result in lower risk of post-thrombotic syndrome (47% vs. 48%, respectively) but did result in higher risk of major bleeding. (1.7% vs. 0.3%, p= 0.049).

 

Individualised versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome (IDEAL DVT): a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial

The Lancet Haematology

This RCT (n=865) reports post-thrombotic syndrome occurred in 29% of patients receiving individualised duration of therapy and 28% of patients receiving standard duration of therapy (absolute difference was 1.1% (95% CI −5.2 to 7.3), thus meeting the non-inferiority margin.

 

Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center

Annals of Internal Medicine

In this discussion, experts review the 2016 US Aspirin Use for the Primary Prevention of Cardiovascular Disease.

 

Thrombo-embolic prevention after transcatheter aortic valve implantation (TAVI)

European Heart Journal

Optimal antithrombotic strategy and duration to mitigate thrombotic and bleeding risks associated with TAVI remains unclear. This review provides an overview of recent insights in this field, and highlights antithrombotic trials focusing on optimising outcomes in this setting.

 

Perioperative management of anticoagulant and antiplatelet therapy

Heart

This narrative review discusses assessment of whether interruption of anticoagulation is required, need for and management of perioperative bridging, management of patients who are receiving direct oral anticoagulants (DOACs) and management of those receiving antiplatelets.

 

 

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services