BrainWaves #77 Bridging the gap

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 21, 2017

Atrial fibrillation increases your risk of clotting. Anticoagulation increases your risk of bleeding. Surgery increases your risk of both. Dr. Mike Rubenstein speaks with Dr. Jim Siegler this week about how providers weigh the risks and benefits of anticoagulant bridging in the perioperative setting.

Produced by Michael Rubenstein and James E Siegler. Music by Chris Zabriskie, Lee Rosevere, and Jason Shaw. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Garcia DA, Regan S, Henault LE, et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med 2008;168(1):63-9. PMID 18195197

Raval AN, Cigarroa JE, Chung MK, et al. Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association. Circulation 2017;135(10):e604-33. Erratum in: Circulation 2017;135(10 ):e647. Erratum in: Circulation 2017;135(24):e1144. PMID 28167634

Rechenmacher SJ, Fang JC. Bridging anticoagulation: primum non nocere. J Am Coll Cardiol 2015;66(12):1392-403. PMID 26383727

Schulman S, Carrier M, Lee AY, et al. Perioperative management of dabigatran: a prospective cohort study. Circulation 2015;132(3):167-73. PMID 25966905

Steinberg BA, Peterson ED, Kim S, et al. Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Circulation 2015;131(5):488-94. PMID 25499873

Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation 1991;84(2):527-39. PMID 1860198

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.