Balancing bleeding,thrombosis and myocardial injury:A call for balance and precision medicine for aspirin in neurosurgery  

作　　者：Subhrashis Guha Niyogi Akash Batta Bishav Mohan 

机构地区：[1]Department of Anesthesia,Tata Main Hospital,Jamshedpur 831001,Jharkhand,India [2]Department of Cardiology,Dayanand Medical College and Hospital,Ludhiana 141001,Punjab,India

出　　处：《World Journal of Cardiology》2024年第12期673-676,共4页世界心脏病学杂志（英文）

摘　　要：Perioperative management of antiplatelet therapy involves a delicate balancing of the risk of periprocedural blood loss with the cardiovascular and thrombotic risk to the patient.Due to the unique nature of neurosurgery,perioperative bleeding may have devastating consequences and cause major morbidity and mortality.The recommendation to discontinue aspirin prior to major neurosurgical procedures rests upon conventional practice,expert consensus with priority given to avoidance of any major bleed.On the contrary recent prospective data do not support the existence of additional bleeding risk in patients continuing aspirin compared to those who stop aspirin prior to procedure.Patients with cardiova-scular and metabolic comorbidities are increasingly encountered in the operation theatre these days.In these patients,prevention of myocardial injury after non-cardiac surgery(MINS)is an important focus for perioperative risk reduction.Prolonged(≥7 days)cessation of antiplatelets is one of the most important predictors of MINS.This complicated milieu of risks and benefits highlights the difficulty of practicing evidence-based medicine and minimizing harm in patients on aspirin needing neurosurgery.

关 键 词：NEUROSURGERY ASPIRIN Myocardial injury after non-cardiac surgery Throm-botic risk Haemorrhagic complications Platelet function assessment 

分 类 号：R542.22[医药卫生—心血管疾病]