Should you stop blood thinners before surgery? AAN guideline provides direction

May 27, 2013

A new guideline from the American Academy of Neurology will help people who take blood thinners decide whether or not to take them during surgery or other medical procedures. The guideline is published in the May 28, 2013, print issue of Neurology, the medical journal of the American Academy of Neurology.

People who have had a stroke often take blood thinners such as aspirin or to prevent another stroke. Blood thinners, or anticlotting drugs, are also used to prevent a first stroke in people with atrial fibrillation, an irregular or fast heartbeat. Blood thinners can prevent from forming that can cause strokes. However, these drugs also can increase the risk of bleeding. Increased bleeding is especially a concern when someone is having a procedure or operation.

"There may be millions of Americans taking anticlotting drugs to prevent a stroke," said guideline author Melissa J. Armstrong, MD, an assistant professor of neurology with the University of Maryland School of Medicine in Baltimore. "For every , minor medical procedure or surgery these people plan to have, they should work with their doctors to decide if these drugs should be continued to maintain efforts or temporarily stopped to lower the risk of bleeding with the procedure."

The risk of bleeding varies depending on the procedure, according to the guideline, which was developed by reviewing all available evidence to date. For many minor procedures, including dental procedures, the bleeding risk from continuing blood thinners is fairly small.

For some other procedures, the risk of bleeding may be higher when blood thinners are continued. Examples are certain hip and colon procedures.

"This guideline helps patients and doctors know what the evidence tells us about these different risks," Armstrong said. "A person's and preferred course of action are also important to discuss when making this decision."

Most of the studies on bleeding risks from blood thinners during procedures focus on aspirin and warfarin. Armstrong said more studies are needed to understand the bleeding risks of other blood thinners, such as clopidogrel and aspirin plus dipyridamole, as well as new anticoagulants such as dabigatran, rivaroxaban or apixaban, during or before procedures.

Some people take blood thinners for heart problems. The guideline did not review evidence for people with heart problems other than .

May is National Stroke Awareness Month.

Explore further: Do blood thinners + stroke treatment = danger? Study indicates the risk is low

More information: www.aan.com/patients

Related Stories

Do blood thinners + stroke treatment = danger? Study indicates the risk is low

March 13, 2013
Millions of Americans take aspirin or other drugs every day to reduce their risk of heart attacks or other problems caused by blood clots.

Strokes associated with surgery can be devastating

February 11, 2013
Strokes that occur during or shortly after surgery can be devastating, resulting in longer hospital stays and increased risks of death or long-term disability.

Blood thinners may boost survival for prostate cancer patients

February 21, 2013
(HealthDay)—Men with advanced prostate cancer might live longer when they are taking blood-thinning medication, a small study suggests.

Apixaban superior to warfarin across range of patient risk scores

October 1, 2012
A new anticoagulant called apixaban is superior to warfarin in preventing stroke with consistent effects across a wide range of stroke and bleeding risk in patients with atrial fibrillation, according to Duke University Medical ...

New blood thinner may lower chances of clots in high-risk heart patients: FDA

May 21, 2012
(HealthDay) -- The new blood thinner Xarelto appears to lower the chances of potentially fatal blood clots in high-risk heart patients, a U.S. Food and Drug Administration review has found.

ACP recommends new approach to prevent venous thromboembolism in hospitalized patients

October 31, 2011
In a new clinical practice guideline published today in Annals of Internal Medicine, the American College of Physicians (ACP) recommends that doctors assess the risk of thromboembolism and bleeding in patients hospitalized ...

Recommended for you

Scientists capture first image of major brain receptor in action

July 24, 2017
Columbia University Medical Center (CUMC) researchers have captured the first three-dimensional snapshots of the AMPA-subtype glutamate receptor in action. The receptor, which regulates most electrical signaling in the brain, ...

Research identifies new brain death pathway in Alzheimer's disease

July 24, 2017
Alzheimer's disease tragically ravages the brains, memories and ultimately, personalities of its victims. Now affecting 5 million Americans, Alzheimer's disease is the sixth leading cause of death in the U.S., and a cure ...

Illuminating neural pathways in the living brain

July 24, 2017
Using light alone, scientists from the Max Planck Institute of Neurobiology in Martinsried are now able to reveal pairs or chains of functionally connected neurons under the microscope. The new optogenetic method, named Optobow, ...

Study suggests link between autism, pain sensitivity

July 24, 2017
New research by a UT Dallas neuroscientist has established a link between autism spectrum disorder (ASD) and pain sensitivity. 

Eye test could help diagnose autism

July 24, 2017
A new study out in European Journal of Neuroscience could herald a new tool that helps physicians identify a sub-group of people with Autism spectrum disorders (ASD). The test, which consists of measuring rapid eye movements, ...

The neural codes for body movements

July 21, 2017
A small patch of neurons in the brain can encode the movements of many body parts, according to researchers in the laboratory of Caltech's Richard Andersen, James G. Boswell Professor of Neuroscience, Tianqiao and Chrissy ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.