Document Detail


Extracorporeal shockwave lithotripsy in patients treated with antithrombotic agents.
MedLine Citation:
PMID:  11339387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PATIENTS AND METHODS: Between January 1996 and December 1999, 749 patients underwent electromagnetic SWL. Among them, 23 patients, 19 with renal and 4 with ureteral stones, were receiving antithrombotic drugs (aspirin, ticlopidine, dipyridamole). According to the cardiologist and hematologist, we divided these patients into two groups: Group 1 had a low thromboembolic risk (previous myocardial infarction), and Group 2 had a high thromboembolic risk (aortocoronary bypass, atrial fibrillation, cerebrovascular disease, peripheral occlusive arterial disease). Group 1 patients discontinued their antiplatelet therapy 8 days prior to SWL to permit a sufficient number of functioning platelets to remain. Group 2 patients suspended antiplatelet therapy, and unfractioned heparin 5000 IU tid (8 a.m., 4 p.m., and 12 p.m.) was administered for the 8 days prior to SWL. On the ninth day of withdrawal, SWL was performed in all patients. Close follow-up was performed during the postoperative period (hemoglobin, hematocrit, kidney ultrasonography, plain abdominal film). The antithrombotic therapy was restored in all patients within 10 to 14 days of withdrawal. RESULTS: Hematomas and thromboembolic events were not observed. At 3 months' follow-up, 14 patients (61%) were stone free, 3 (13%) had <4-mm fragments, and 6 (26%) had >4-mm residual fragments. CONCLUSION: Our schedules for the suspension or substitution of antithrombotic therapy, although tested in a small number of patients, allowed us to perform SWL without hemorrhagic or thromboembolic complications.
Authors:
G Zanetti; I Kartalas-Goumas; E Montanari; A B Federici; A Trinchieri; F Rovera; E Pisani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  15     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-07     Completed Date:  2001-09-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-41     Citation Subset:  IM    
Affiliation:
Institute of Urology, Angelo Bianchi Bonomi Haemophilia Thrombosis Centre, Ospedale Maggiore, Italy. gp.zanett@tiscalinet.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use
Female
Follow-Up Studies
Heparin / therapeutic use
Humans
Lithotripsy*
Male
Middle Aged
Platelet Aggregation Inhibitors / administration & dosage*,  therapeutic use
Risk Factors
Thromboembolism / etiology
Urinary Calculi / therapy*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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