How to Avoid and Manage CIED Implantation-Related Complications-Pocket Hematoma Prevention: Lessons learned from Bruise Control I and II (Presenter: David H. Birnie, MD)

Pocket Hematoma Prevention: Lessons learned from Bruise Control I and II (Presenter: David H. Birnie, MD)

Video Transcription

Video Summary

In this video, the speaker discusses the lessons learned from the Bruise Control 1 and 2 trials regarding pocket hematoma prevention. Hematomas can have negative effects on patients, causing pain and leading to prolonged cessation of anticoagulation. They can also increase the risk of infection, with patients who develop hematomas having a higher risk of infection compared to those without hematomas. The speaker emphasizes that heparin bridging should never be used, as it has been shown to increase the risk of hematoma compared to continued warfarin therapy. When it comes to direct oral anticoagulants (DOACs), the speaker suggests that interruption or continuation of DOAC therapy around device surgery is reasonable, depending on the individual patient's risk for stroke. Finally, the speaker highlights the importance of considering antiplatelet agents, as they have been found to double the rate of clinically significant hematoma. Overall, the speaker provides four main lessons: hematomas are bad for patients, heparin bridging should never be used, DOAC therapy can be interrupted or continued depending on the patient's risk profile, and antiplatelets should also be taken into account in hematoma prevention.

Meta Tag

Lecture ID 7254

Location Room 155

Presenter David H. Birnie, MD

Role Invited Speaker

Session Date and Time May 10, 2019 4:30 PM - 6:00 PM

Session Number S-088

Keywords

pocket hematoma prevention

hematomas

infection risk

heparin bridging

DOAC therapy

device surgery

antiplatelet agents