Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy

Abstract

Oral surgeons, cardiologists, general physicians, and patients should be aware of the increased bleeding risk after oral surgical procedures. Close observation up to 1 week postoperatively is advisable to prevent excessive bleeding.

Perioperative Management in Patients With Undergoing Direct Oral Anticoagulant Therapy in Oral Surgery – A Multicentric Questionnaire Survey

“…This is in line with the findings of Clemm et al, who reported a higher bleeding rate for patients treated with VKAs than with DOACs (19). Although Hanken et al found a bleeding rate of 11.5% after minor oral surgery in patients undergoing rivaroxaban therapy (20). Interestingly, 34.6% of the participants of our study ranked the bleeding risk of LMWH therapy as very high or high.…”

World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis

“…Of the six studies, one study was assessed as good quality, four were evaluated as fair quality, and one of poor quality (Table ). Risk of bias of the 21 studies was assessed using the Newcastle‐Ottawa scale: two studies received a low risk of bias score (seven stars, Miller & Miller, ; Zeevi et al., ), 16 studies received a high risk of bias score (six stars, Andrade et al., ; Berton et al., ; Caliskan et al., ; Clemm et al., ; Gómez‐Moreno et al., , ; Hanken et al., ; Kwak et al., ; Lababidi et al., ; Mauprivez et al., ; Miclotte et al., ; Miranda et al., ; Morimoto et al., ; Patel et al., ; Yagyuu et al., and five stars, Johnston, ), and three case‐series received a very high risk of bias score (one star, Abayon et al., ; Breik et al., ; Hassona et al., ; Table ).…”

“…None of the included studies was a randomized controlled trial (RCT). Nine articles were prospective case-control studies (Andrade et al, 2018;Berton et al, 2018;Caliskan, Tükel, Benlidayi, & Deniz, 2017;Clemm et al, 2016;Gómez-Moreno et al, 2016Mauprivez et al, 2016;Miclotte et al, 2017;Miranda et al, 2016), four were retrospective case-control studies (Hanken et al, 2016;Kwak et al, 2018;Lababidi et al, 2018;Yagyuu et al, 2017), and five studies were retrospective (Johnston, 2015;Miller & Miller, 2018;Morimoto, Yokoe, Imai, Sugihara, & Futatsuki, 2016;Zeevi et al, 2017) and prospective (Patel et al, 2017) observational studies, reporting data from medical records. Three studies were case-series (Abayon, Kolokythas, Siu, & Elad, 2016;Breik, Cheng, Sambrook, & Goss, 2014;Hassona, Malamos, Shaqman, Baqain, & Scully, 2018).…”

“…Johnston, 2015;Kwak et al, 2018;Lababidi et al, 2018;Miller & Miller, 2018;Patel et al, 2017;Zeevi et al, 2017) and two caseseries studies(Breik et al, 2014 andHassona et al, 2018) reported on a direct comparison between these two groups of patients. The remaining 13 articles analyzed bleeding events in patients who had all discontinued DOAC therapy before surgery(Abayon et al, 2016;Gómez-Moreno et al, 2018;Miclotte et al, 2017) or who continued it unchanged(Andrade et al, 2018;Berton et al, 2018;Caliskan et al, 2017;Clemm et al, 2016;Gómez-Moreno et al, 2016;Hanken et al, 2016;Mauprivez et al, 2016;Miranda et al, 2016;Morimoto et al, 2016;Yagyuu et al, 2017). The majority of these 13 studies compared patients taking DOAC therapy with healthy patients not taking any anticoagulation therapies or with patients treated with VKAs.…”

Protocolo de atendimento odontológico a pacientes usuários de terapia antitrombótica

“…Hanken et al 46 (2016) recomendam que procedimentos múltiplos sejam divididos em várias sessões, a fim de reduzir o risco de sangramento, lembrando que a complexidade do procedimento é também determinada pelo fato de envolver osteotomia e/ou retalho. A incidência de hemorragia pós--operatória foi maior após extrações dentárias que envolviam retalho e/ou osteotomia 32 .…”