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Current practice in the use of antiplatelet agents in the peri-operative period by UK vascular surgeons

Lookup NU author(s): Dr Jonathan Smout, Professor Gerard Stansby

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Abstract

Background: There currently appears to be no firm consensus with regards to the use of antiplatelet agents during the peri-operative period in vascular surgical practice. Methods: A nine-part questionnaire relating to peri-operative antiplatelet use was sent to 137 ordinary members of the Vascular Surgical Society of Great Britain and Ireland (VSS-GBI). Results: Of the 137 questionnaires sent, 90 were returned (66%). For patients undergoing infra-inguinal bypass, carotid endarterectomy and varicose vein surgery, over 90% of vascular surgeons continue antiplatelet agents peri-operatively; however, in the case of aortic aneurysm repair, this figure is lower (77%). Three of the respondents stated that they would stop clopidogrel, but not aspirin, prior to surgery because of concerns over increased operative bleeding. In patients starting routine heparin prophylaxis against thrombosis, most surgeons opted to continue antiplatelet therapy (82%), although in patients requiring therapeutic heparin treatment, opinions were almost equally split. Most vascular surgeons (93%) would to start an alternative antiplatelet agent if a patient was intolerant of aspirin for gastrointestinal reasons. Conclusions: Although the benefits of antiplatelet drugs in the long-term reduction of vascular events is established, evidence supporting their use in the peri-operative period is scarce. The general consensus of opinion from this survey suggests that most vascular surgeons do not stop antiplatelet drugs preoperatively.


Publication metadata

Author(s): Smout J, Stansby G

Publication type: Article

Publication status: Published

Journal: Annals of the Royal College of Surgeons of England

Year: 2003

Volume: 85

Issue: 2

Pages: 97-101

ISSN (print): 0035-8843

ISSN (electronic): 1478-7083

Publisher: Royal College of Surgeons of England

URL: http://dx.doi.org/10.1308/003588403321219858

DOI: 10.1308/003588403321219858

PubMed id: 12648338


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