Zentralbl Chir 2013; 138(03): 219-221
DOI: 10.1055/s-0033-1349266
Aktuelle Chirurgie
Georg Thieme Verlag KG Stuttgart · New York

Plättchenaggregationshemmung in der Viszeralchirurgie – Die wichtigsten Aspekte zur Risikoabwägung

Further Information

Publication History

Publication Date:
02 July 2013 (online)

Die Einschätzung des perioperativen Risikos von Blutungskomplikationen und thrombembolischen Ereignissen bei Patienten unter Plättchenhemmung hat sich gewandelt. Unter Inkaufnahme eines vermeintlich höheren Blutungsrisikos wird immer häufiger unter fortgeführter Plättchenhemmung operiert. Welche Rolle spielt die einfache und doppelte Plättchenhemmung in der Viszeralchirurgie?

 
  • Literatur

  • 1 Jambor C, Spannagl M, Zwissler R. Perioperatives Management von Patienten mit Thrombozytenaggregationshemmung bei Koronarstents. Passion Chirurgie 2012; 2 (Suppl. 06) Artikel 02_02
  • 2 Rasche S, Schöne S, Koch T. Der Patient nach Koronarintervention in der perioperativen Medizin. Anästh Intensivmed 2010; 51: 623-636
  • 3 Ho PM, Peterson ED, Wang L et al. Incidence of death and acute myocardial infarction associated with stopping clopidogrel after acute coronary syndrome. JAMA 2008; 299: 532-539
  • 4 Mantz J, Samama CM, Tubach F et al. Stratagem Study Group. Impact of preoperative maintenance or interruption of aspirin on thrombotic and bleeding events after elective non-cardiac surgery: the multicentre, randomized, blinded, placebo-controlled, STRATAGEM trial. Br J Anaesth 2011; 107: 899-910
  • 5 Oscarsson A, Gupta A, Fredrikson M et al. To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial. Br J Anaesth 2010; 104: 305-312
  • 6 Antolovic D, Rakow A, Contin P et al. A randomised controlled pilot trial to evaluate and optimize the use of anti-platelet agents in the perioperative management in patients undergoing general and abdominal surgery – the APAP trial (ISRCTN45810007). Langenbecks Arch Surg 2012; 397: 297-306
  • 7 Burger W, Chemnitius JM, Kneissl GD et al. Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. J Int Med 2005; 257: 399-414
  • 8 Chernoguz A, Telem DA, Chu E et al. Major abdominal surgery with continued dual antiplatelet therapy. Arch Surg 2011; 146: 334-339
  • 9 Quante M, Benckert C, Thelen A et al. Major abdominal surgery with continued dual antiplatelet therapy. Arch Surg 2011; 146: 1334-1335
  • 10 Kapetanakis EI, Medlam DA, Boyce SW et al. Clopidogrel administration prior to coronary artery bypass grafting surgery: the cardiologist’s panacea or the surgeon’s headache?. Eur Heart J 2005; 26: 576-583
  • 11 Task force for preoperative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery; European Society of Cardiology (ESC). Poldermans D et al. Guidelines for preoperative risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J 2009; 30: 2769-2812
  • 12 Metzler H, Huber K, Kozek-Langenecker S et al. Koronare Stents, duale Antiplättchentherapie und die perioperative Problematik. Anaesthesist 2007; 56: 401-410