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Research Letter
Association of VA Surgeons
March 2018

Assessing the Necessity of Stopping Antithrombotic Agents Before Wide-Awake Hand Surgery

Author Affiliations
  • 1Division of Plastic Surgery, Department of Surgery, Indiana University, Indianapolis
  • 2Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana
JAMA Surg. 2018;153(3):284-285. doi:10.1001/jamasurg.2017.3927

Many patients requiring carpal tunnel release (CTR) surgery are taking long-term antithrombotic (AT) agents for various medical conditions. This presents a challenge for hand surgeons, who must weigh the risk of bleeding if AT therapy is continued against the risk of thrombosis if AT therapy is temporarily stopped. Previous studies have shown that it is safe to continue AT therapy in patients undergoing dermatologic, cataract, and dental surgery;1 however, to our knowledge, there is no consensus on the management of oral AT agents in elective hand surgery.2-4 The goal of this study is to evaluate the safety of continuing AT use in the perioperative period in wide-awake CTR using an open surgical technique.

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