Antithrombotic Treatment Management in Patients with Intracerebral Hemorrhage: Reversal and Restart
| Autor: | George A. Alexiou, Kostas Themistoklis, Pantelis Stathis, Marios Themistocleous, Manolis Vavuranakis, Dimitrios A. Vrachatis, Dimitrios Giakoumettis |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pharmacology
Intracerebral hemorrhage medicine.medical_specialty business.industry Mortality rate Anticoagulants Atrial fibrillation 030204 cardiovascular system & hematology medicine.disease Surgery Discontinuation 03 medical and health sciences Antithrombotic treatment 0302 clinical medicine Drug Discovery Antithrombotic medicine Humans Neurosurgery Intensive care medicine business Stroke 030217 neurology & neurosurgery Cerebral Hemorrhage |
| Zdroj: | Current Pharmaceutical Design. 23:1392-1405 |
| ISSN: | 1381-6128 |
| DOI: | 10.2174/1381612822666161205111459 |
| Popis: | Background: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages. Objective: The aim of this article is to review current literature for intracerebral hemorrhage and antithrombotic therapy and offer recommendations on the reversal, the discontinuation and the resumption of antithrombotic therapy. Methods and Materials: Current literature has been reviewed for intracerebral hemorrhage associated with three major categories of patients, those with atrial fibrillation, those with prosthetic mechanical valves and those with venous thromboembolism. Antithrombotic therapy is categorized in antiplatelet agents and anticoagulants. The risk of intracerebral hemorrhage, of a thromboembolic event and of a rebleeding with or without antithrombotic therapy was also reported. Conclusion: Although no one can deny the usefulness of antithrombotic therapy a therapeutic strategy should be developed in order to optimize the clinical decision of stopping, reversing and restarting antithrombotic treatment. This review concludes in strong recommendations, yet a multidisciplinary panel by a stroke physician or neurologist, a cardiologist, a neuroradiologist and a neurosurgeon should evaluate the benefits and the risks for each patient and decide the best therapeutic strategy. |
| Databáze: | OpenAIRE |
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