Direct Oral Anticoagulants
jeudi 6 juin 2019
Posted by: Paola Pino
Continuation of direct oral anticoagulants in oral surgery – a literature review
Implant placement and augmentation procedures are associated with the risk of haemorrhaging, particularly in patients on anti-coagulants. A recent literature review from the Medical University of Graz has summarised strategies for treating patients who are receiving direct oral anticoagulants (DOACs).
A systematic search of high-yield journals and the electronic database ‘PubMed’ was carried out by the researchers. Search terms included ‘DOAC’, ‘oral surgery’ and ‘implant surgery’ to find a broad spectrum of perioperative haemostatic strategies.
Five studies were identified as being relevant. Two of the studies compared continuation of DOAC with discontinuation. Three of the studies found no significance for bleeding events in patients on DOACs, when compared to procedures involving patients not on anticoagulants.
Based on the studies reviewed, the authors found that simple implant placements do not increase risk of haemorrhaging, and so continuation of DOACs is advisable. For more complex cases, suspending the use of DOACs may help limit the risk of complications. The author’s note that further studies are required to better determine the factors associated with haemorrhaging and to find the best strategy to reduce bleeding.
This study was presented as an e-poster at the 2018 EAO Congress.