PMID- 37168014
OWN - NLM
STAT- MEDLINE
DCOM- 20240403
LR  - 20240403
IS  - 2193-6323 (Electronic)
IS  - 2193-6315 (Linking)
VI  - 85
IP  - 3
DP  - 2024 May
TI  - Management of Patients undergoing Elective Craniotomy under Antiplatelet or 
      Anticoagulation Therapy: An International Survey of Practice.
PG  - 246-253
LID - 10.1055/s-0043-1767724 [doi]
AB  - BACKGROUND:  The literature concerning the management of antiplatelet (AP) and 
      anticoagulation (AC) medication in the perioperative phase of craniotomy remains 
      scarce. The aim of this international survey was to investigate the current 
      practice among neurosurgeons regarding their perioperative management of AP and 
      AC medication. METHODS:  We distributed an online survey to neurosurgeons 
      worldwide with questions concerning their perioperative practice with AP and AC 
      medication in patients undergoing craniotomy. Descriptive statistics were 
      performed. RESULTS:  A total of 130 replies were registered. The majority of 
      responders practice neurosurgery in Europe (79%) or high-income countries (79%). 
      Responders reported in 58.9 and 48.8% to have institutional guidelines for the 
      perioperative management of AP and AC medication. Preoperative interruption time 
      was reported heterogeneously for the different types of AP and AC medication with 
      40.4% of responders interrupting aspirin (ASA) for 4 to 6 days and 45.7% 
      interrupting clopidogrel for 6 to 8 days. Around half of the responders 
      considered ASA safe to be continued or resumed within 3 days for bypass (55%) or 
      vascular (49%) surgery, but only few for skull base or other tumor craniotomies 
      in general (14 and 26%, respectively). Three quarters of the responders (74%) did 
      not consider AC safe to be continued or resumed early (within 3 days) for any 
      kind of craniotomy. ASA was considered to have the lowest risk of bleeding. 
      Nearly all responders (93%) agreed that more evidence is needed concerning AP and 
      AC management in neurosurgery. CONCLUSION:  Worldwide, the perioperative 
      management of AP and AC medication is very heterogeneous among neurosurgeons.
CI  - Thieme. All rights reserved.
FAU - Greuter, Ladina
AU  - Greuter L
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
FAU - Rychen, Jonathan
AU  - Rychen J
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
FAU - Chiappini, Alessio
AU  - Chiappini A
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
FAU - Mariani, Luigi
AU  - Mariani L
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
AD  - Faculty of Medicine, University of Basel, Basel, Switzerland.
FAU - Guzman, Raphael
AU  - Guzman R
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
AD  - Faculty of Medicine, University of Basel, Basel, Switzerland.
FAU - Soleman, Jehuda
AU  - Soleman J
AD  - Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
AD  - Faculty of Medicine, University of Basel, Basel, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20230511
PL  - Germany
TA  - J Neurol Surg A Cent Eur Neurosurg
JT  - Journal of neurological surgery. Part A, Central European neurosurgery
JID - 101580767
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Anticoagulants)
RN  - R16CO5Y76E (Aspirin)
RN  - A74586SNO7 (Clopidogrel)
SB  - IM
MH  - Humans
MH  - *Platelet Aggregation Inhibitors/therapeutic use
MH  - *Anticoagulants/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Clopidogrel
MH  - Craniotomy
COIS- None declared.
EDAT- 2023/05/12 01:07
MHDA- 2024/04/03 06:43
CRDT- 2023/05/11 19:03
PHST- 2024/04/03 06:43 [medline]
PHST- 2023/05/12 01:07 [pubmed]
PHST- 2023/05/11 19:03 [entrez]
AID - 10.1055/s-0043-1767724 [doi]
PST - ppublish
SO  - J Neurol Surg A Cent Eur Neurosurg. 2024 May;85(3):246-253. doi: 
      10.1055/s-0043-1767724. Epub 2023 May 11.