Perioperative Therapie mit Thrombozytenaggregationshemmern

Perioperative therapy with antiplatelet agents

Zusammenfassung

Thrombozytenaggregationshemmer werden zur Verhinderung arterieller thromboembolischer Komplikationen eingesetzt. Im klinischen Alltag müssen die Risiken perioperativer Blutung und schwerwiegender thromboembolischer Komplikationen abgewogen werden, wenn Plättchenhemmer abgesetzt werden. Bei der Beendigung der Therapie müssen sowohl die Indikation als auch der Zeitpunkt des Absetzens sorgfältig gewählt werden. In keinem Fall sollte das individuelle Risiko unterschätzt werden. Vor allem Patienten mit stattgehabter koronarer Stentimplantation sind vital gefährdet, wenn die duale Plättchenhemmung vorzeitig, d. h. vor kompletter Endothelialisierung des Stents beendet wird.

Abstract

Antiplatelet therapy is used to prevent thromboembolic complications in patients with artherothrombotic disease. In clinical routine an assessment of the risk of perioperative bleeding must be weighed against the risk of thromboembolic complications in the event of discontinuation of antiplatelet agents. The indications as well as the timepoint for the termination of antiplatelet therapy are important issues to consider. The premature interruption of oral antiplatelet therapy with recovery of platelet function may lead to recurrence of thromboembolic events. Especially patients with intracoronary stents are at threat when the dual platelet therapy is interrupted before complete endothelialization of the stent.

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Lepper, W., Kelm, M. Perioperative Therapie mit Thrombozytenaggregationshemmern. Anaesthesist 56, 592–598 (2007). https://doi.org/10.1007/s00101-007-1187-8

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Schlüsselwörter

  • Thrombozytenaggregationshemmer
  • Acetylsalicylsäure
  • Clopidogrel
  • Akutes Koronarsyndrom
  • Präoperative Therapie
  • Stentimplantation

Keywords

  • Antiplatelet agents
  • Aspirin
  • Clopidogrel
  • Acute coronary syndrome
  • Preoperative therapy
  • Stent implantation