Management Guidelines | Disciplines | Radiology Subspecialties | Interventional

Patel IJ, Davidson JC, Nikolic B, et al
J Vasc Interv Radiol
Hematologic management in the patient undergoing percutaneous imageguided intervention is complex because of the wide range of procedures and equally wide range of patient demographics and comorbidities. Concurrent increases in the use of short- and long-term anticoagulation, as well as the increasing use of antiplatelet agents, further complicates the periprocedural management of these patients. Despite the continuing increase in the volume of percutaneous image-guided procedures, there is a general paucity of data regarding the periprocedural management of the patient with abnormal coagulation parameters. In the absence of data, clinicians may respond to the patient with abnormal coagulation parameters by canceling or postponing the procedure, altering an otherwise indicated procedure, or infusing blood products such as fresh frozen plasma (FFP) or platelets. Recommendations from open surgical experience can be extrapolated, but may not be completely applicable to interventional procedures because, in open cases, the operator is typically able to directly visualize and promptly control any bleeding complications. Finally, medicolegal factors may influence the management of the patient, as clinicians feel the need to “correct” an abnormal coagulation factor, despite the fact that studies of bleeding complications in percutaneous procedures have not shown a correlation between mild to moderate abnormality of preprocedural coagulation parameters and a higher incidence of bleeding complications.

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Patel IJ, Davidson JC, Nikolic B, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23:727-736
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August 5 2016

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