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      Management of anticoagulant and antiplatelet therapy in patients undergoing interventional pulmonary procedures

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          There has been great progress in antithrombotic therapy over the past several years. Its use has increased with the advent of novel anticoagulants, as these medications do not require frequent blood tests for monitoring. Antithrombotic therapy is aimed at reducing the risk of thromboembolic events in patients with atrial fibrillation, coronary artery disease, deep vein thrombosis, valvular heart disease and pulmonary embolism. These patients are often critically ill and frequently undergo urgent interventions requiring discontinuation of anticoagulant or antiplatelet therapy which can increase the risk of thrombosis; however, continuing these agents can lead to increased risk of haemorrhage.

          The purpose of this article is to summarise the literature surrounding the safety of using antiplatelet and anticoagulant therapies in patients undergoing interventional pulmonary procedures.

          Abstract

          Available studies suggest some antithrombotic agents may be used in interventional pulmonary procedures http://ow.ly/vSF030bRqjt

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          2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions.

          Glenn N Levine, Eric R. Bates, James Blankenship … (2011)
          Article 0 comments Cited 164 times – based on 0 reviews     Review now
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            British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE.

            I Du Rand, J. Blaikley, R Booton … (2013)
            Article 0 comments Cited 139 times – based on 0 reviews     Review now
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              Asthma control during the year after bronchial thermoplasty.

              Ian Pavord, Neil Thomson, Paul Corris … (2007)
              Bronchial thermoplasty is a bronchoscopic procedure to reduce the mass of airway smooth muscle and attenuate bronchoconstriction. We examined the effect of bronchial thermoplasty on the control of moderate or severe persistent asthma. We randomly assigned 112 subjects who had been treated with inhaled corticosteroids and long-acting beta2-adrenergic agonists (LABA) and in whom asthma control was impaired when the LABA were withdrawn to either bronchial thermoplasty or a control group. The primary outcome was the frequency of mild exacerbations, calculated during three scheduled 2-week periods of abstinence from LABA at 3, 6, and 12 months. Airflow, airway responsiveness, asthma symptoms, the number of symptom-free days, use of rescue medication, and scores on the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) were also assessed. The mean rate of mild exacerbations, as compared with baseline, was reduced in the bronchial-thermoplasty group but was unchanged in the control group (change in frequency per subject per week, -0.16+/-0.37 vs. 0.04+/-0.29; P=0.005). At 12 months, there were significantly greater improvements in the bronchial-thermoplasty group than in the control group in the morning peak expiratory flow (39.3+/-48.7 vs. 8.5+/-44.2 liters per minute), scores on the AQLQ (1.3+/-1.0 vs. 0.6+/-1.1) and ACQ (reduction, 1.2+/-1.0 vs. 0.5+/-1.0), the percentage of symptom-free days (40.6+/-39.7 vs. 17.0+/-37.9), and symptom scores (reduction, 1.9+/-2.1 vs. 0.7+/-2.5) while fewer puffs of rescue medication were required. Values for airway responsiveness and forced expiratory volume in 1 second did not differ significantly between the two groups. Adverse events immediately after treatment were more common in the bronchial-thermoplasty group than in the control group but were similar during the period from 6 weeks to 12 months after treatment. Bronchial thermoplasty in subjects with moderate or severe asthma results in an improvement in asthma control. (ClinicalTrials.gov number, NCT00214526 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur Respir Rev
                Journal ID (iso-abbrev): Eur Respir Rev
                Journal ID (publisher-id): ERR
                Journal ID (hwp): errev
                Title: European Respiratory Review
                Publisher: European Respiratory Society
                ISSN (Print): 0905-9180
                ISSN (Electronic): 1600-0617
                Publication date Collection: 30 September 2017
                Publication date (Electronic): 19 July 2017
                Volume: 26
                Issue: 145
                Electronic Location Identifier: 170020
                Affiliations
                [1 ]Dept of Pulmonary Disease and Critical Care Medicine, WakeMed Health and Hospitals, Raleigh, NC, USA
                [2 ]Dept of Pharmacy, WakeMed Health and Hospitals, Raleigh, NC, USA
                Author notes
                Vikas Pathak, Pulmonary and Critical Care Medicine, WakeMed Health and Hospitals, Raleigh, NC 27610, USA. E-mail: drvikaspathak@ 123456gmail.com
                Article
                Publisher ID: ERR-0020-2017
                DOI: 10.1183/16000617.0020-2017
                PMC ID: 9488580
                PubMed ID: 28724563
                SO-VID: 4685067f-75cf-40de-b960-ad6fef17a9fc
                Copyright © Copyright ©ERS 2017.
                License:

                ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                Date received : 11 March 2017
                Date accepted : 05 May 2017
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                Subject: Reviews
                Subject: 14
                Subject: 18

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