2016
DOI: 10.1590/0004-282x20160098
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Lumbar puncture in patients using anticoagulants and antiplatelet agents

Abstract: The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the th… Show more

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Cited by 14 publications
(11 citation statements)
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“…For the use of NOAK (new oral [or non-vitamin K-dependent] anticoagulants) such as dabigatran, rivaroxaban, apixaban, and edoxaban for the prophylaxis or therapy of thromboembolic events no systematic studies are available. Initial recommendations [ 39 ] consider emergency punctures under therapy in vital indications. Elective punctures of the CSF space should be carried out - if medically justifiable - after interrupting the NOAK according to the respective half-life, considering renal function, in particular for dabigatran (usually 2-3 days, for dabigatran and GFR [glomerular filtration rate] below 50 ml/min > 3 days).…”
Section: Diagnostic Lumbar Puncturementioning
confidence: 99%
See 1 more Smart Citation
“…For the use of NOAK (new oral [or non-vitamin K-dependent] anticoagulants) such as dabigatran, rivaroxaban, apixaban, and edoxaban for the prophylaxis or therapy of thromboembolic events no systematic studies are available. Initial recommendations [ 39 ] consider emergency punctures under therapy in vital indications. Elective punctures of the CSF space should be carried out - if medically justifiable - after interrupting the NOAK according to the respective half-life, considering renal function, in particular for dabigatran (usually 2-3 days, for dabigatran and GFR [glomerular filtration rate] below 50 ml/min > 3 days).…”
Section: Diagnostic Lumbar Puncturementioning
confidence: 99%
“…Approval was granted in the first half of 2019 in Germany. If discontinuation of NOAK is associated with increased thromboembolic risk, conversion to heparin (bridging) is recommended [ 39 , 111 ].…”
Section: Diagnostic Lumbar Puncturementioning
confidence: 99%
“…Recently, we and others described phosphorylated neurofilament heavy chain (pNfH) in cerebrospinal fluid (CSF) as a diagnostic biomarker for ALS 9–11. However, obtaining CSF by lumbar puncture (LP) can be a limiting factor due to the invasiveness and contraindications such as the use of anticoagulants 12. Therefore, a blood-based biomarker, which can be obtained by a simple venipuncture, would be a valuable alternative if the same diagnostic performance is achieved.…”
Section: Introductionmentioning
confidence: 99%
“…Before anticoagulation or platelet inhibition is commenced, the indication for lumbar puncture should be evaluated as antiplatelet and anticoagulant drugs increase the risk of hemorrhagic complication, for example, spinal hematoma (83).…”
Section: Anticoagulation and Acute Recanalization Therapiesmentioning
confidence: 99%