TITLE

Clinical review: gastrointestinal bleeding after percutaneous coronary intervention: a deadly combination

AUTHOR(S)
P. Foley; S. Foley; T. Kinnaird; R.A. Anderson
PUB. DATE
June 2008
SOURCE
QJM: An International Journal of Medicine;Jun2008, Vol. 101 Issue 6, p425
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Managing gastrointestinal bleeding in a patient who has undergone recent percutaneous coronary intervention requires balancing the risk of stent thrombosis against further catastrophic bleeding. Stent thrombosis and severe gastrointestinal bleeding are life-threatening complications. Aims: To evaluate the risks of gastrointestinal bleeding in patients undergoing percutaneous coronary intervention in relation to anti-platelet therapy and to discuss management of gastrointestinal bleeding in these patients. Design: Review of published studies comparing anti-platelet and ulcer healing therapy. A review of the evidence surrounding the management of gastrointestinal bleeding and the need for anti-platelet therapy in patients undergoing percutaneous coronary intervention. Findings: Gastrointestinal bleeding is relatively common after percutaneous coronary intervention. In one study it complicated 2.3% of primary angioplasty, and these patients had a mortality of 10%. Recent registry data of patients experiencing a gastrointestinal bleed reported a mortality of 5.4%. Cessation of anti-platelet therapy carries a high risk of acute stent thrombosis, which has a high mortality. Conclusions: Individualized specialist gastrointestinal and cardiological management of these patients in a high dependency environment is recommended. Supportive care and proton pump inhibition in combination with judicious use of anti-platelet therapy is likely to provide the best balance of risk.
ACCESSION #
33044650

 

Related Articles

  • Outcome of the Rhomboid Flap for Recurrent Pilonidal Disease. Carriquiry, Luis A. // World Journal of Surgery;May2009, Vol. 33 Issue 5, p1069 

    In this article the author discusses topic related to the use of excision and transposition of a rhomboid flap in treating a series of recurrent pilonidal dieses presented by O. el-Khadraway and company. The author emphasize that the technique deserve further widespread use in recurrent...

  • Review of Thrombophilic States. Beck, Michael J.; Berman, Brian // Clinical Pediatrics;Apr2005, Vol. 44 Issue 3, p193 

    The article states that Venous thromboembolic events remain one of the leading causes of morbidity and mortality in adults. It was not until the early 1980s that the first inherited defect that predisposes to a prothrombotic state was described. Since that discovery, many genetically determined...

  • Early and individualized goal-directed therapy for trauma-induced coagulopathy.  // Scandinavian Journal of Trauma, Resuscitation & Emergency Medici;2012, Vol. 20 Issue 1, p15 

    The article focuses on the review presented by Herbert Schöchl and colleagues on the study of early and individualized goal-directed therapy related to trauma-induced coagulopathy. It mentions that bleeding related to trauma is associated with high mortality. It offers information on...

  • Management in of intracranial bleeding anticoagulated patients. Thompson, Andrew // British Journal of Hospital Medicine (17508460);Jun2009, Vol. 70 Issue 6, p336 

    The article focuses on the research which examines how to prevent mortality rates due to intracerebral hemorrhage complications of anticoagulation. An experimental study showed that rapid reversal of warfarin could contribute an increase of risks in thrombosis and embolism of anticoagulated...

  • Impact of Anticoagulation on Rebleeding Following Endoscopic Therapy for Nonvariceal Upper Gastrointestinal Hemorrhage. Wolf, Anne T.; Wasan, Sharmeel K.; Saltzman, John R. // American Journal of Gastroenterology;Feb2007, Vol. 102 Issue 2, p290 

    OBJECTIVE: Endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage achieves hemostasis in greater than 90% of patients, but up to 20% rebleed. The aim of this study was to determine the impact of anticoagulation on rebleeding in patients undergoing endoscopic therapy for nonvariceal...

  • Supplementation of fibrinogen in acquired bleeding disorders: experience, evidence, guidelines, and licences. Ranucci, M.; Solomon, C. // BJA: The British Journal of Anaesthesia;Aug2012, Vol. 109 Issue 2, p135 

    No abstract available.

  • Letters. Cárdenas Suri, Hisyovi // MEDICC Review;Apr2015, Vol. 17 Issue 2, p5 

    A letter to the editor is presented in response to the article "Zero in on Postpartum Hemorrhage to Reduce Cuba's Maternal Mortality," in the December 2014 issue.

  • Aspirin shows promise after knee surgery.  // Reactions Weekly;3/15/2008, Issue 1193, p4 

    The article presents findings of a study on the effectiveness of the use of aspirin as an alternative therapy to prevent blood clots following knee surgery. According to the study presented at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons, the use of aspirin may be an...

  • Minimally Invasive Subcortical Parafascicular Transsulcal Access for Clot Evacuation (Mi SPACE) for Intracerebral Hemorrhage. Ritsma, Benjamin; Kassam, Amin; Dowlatshahi, Dariush; Nguyen, Thanh; Stotts, Grant // Case Reports in Neurological Medicine;2014, p1 

    Background. Spontaneous intracerebral hemorrhage (ICH) is common and causes significant mortality and morbidity. To date, optimal medical and surgical intervention remains uncertain. A lack of definitive benefit for operative management may be attributable to adverse surgical effect, collateral...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics