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接受介入技术及抗血小板和抗凝治疗患者的围手术期管理:一项平衡之举

Perioperative Management of Patients Receiving Interventional Techniques and Antiplatelet and Anticoagulant Therapy: A Balancing Act.

作者信息

Manchikanti Laxmaiah, Kaye Alan D, Nampiaparampil Devi E, Sanapati Mahendra R, Abd-Elsayed Alaa, Shekoohi Sahar, Hirsch Joshua A

机构信息

Pain Management Centers of America, Paducah, KY, USA.

Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA.

出版信息

Curr Pain Headache Rep. 2025 Sep 18;29(1):107. doi: 10.1007/s11916-025-01405-z.

Abstract

PURPOSEOF REVIEW

This article aims to evaluate current evidence and guidelines on anticoagulant and antiplatelet therapy for patients undergoing interventional procedures. It provides recommendations for managing these therapies with either continuation or withholding of these drugs in the perioperative period to minimize the risk of bleeding and thromboembolism in clinical practice.

RECENT FINDINGS

Newly published guidelines and research underscore the crucial role of antiplatelet and anticoagulant therapy in interventional procedures, emphasizing the importance of decisions regarding whether to continue or temporarily stop these medications. Studies have categorized procedures into low-, moderate-, and high-risk groups, offering specific guidance on managing anticoagulant and antiplatelet therapy accordingly. The American Society of Interventional Pain Physicians (ASIPP) has developed consensus guidelines based on a synthesis of the best available evidence, incorporating risk stratification and practical recommendations. This review provides an in-depth analysis of medical, surgical, and interventional pain management literature. It highlights the updated ASIPP guidelines and summarizes the society's evidence-based recommendations for clinical practice.

摘要

综述目的

本文旨在评估接受介入手术患者的抗凝和抗血小板治疗的现有证据及指南。它提供了在围手术期继续或停用这些药物来管理这些治疗的建议,以在临床实践中最小化出血和血栓栓塞风险。

最新发现

新发布的指南和研究强调了抗血小板和抗凝治疗在介入手术中的关键作用,强调了关于是否继续或暂时停用这些药物的决策的重要性。研究已将手术分为低、中、高风险组,并据此对抗凝和抗血小板治疗的管理提供了具体指导。美国介入疼痛医师协会(ASIPP)基于最佳可用证据的综合制定了共识指南,纳入了风险分层和实用建议。本综述对医学、外科和介入疼痛管理文献进行了深入分析。它突出了最新的ASIPP指南,并总结了该协会基于证据的临床实践建议。

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