BENEFÍCIO DA HIPOCOAGULAÇÃO APÓS PONTAGEM DO MEMBRO INFERIOR — UMA REVISÃO SISTEMÁTICA DA LITERATURA
DOI:
https://doi.org/10.48750/acv.86Palavras-chave:
Doença arterial periférica, tratamento endovascular, calcificaçãoResumo
Introdução: Após revascularização cirúrgica do membro inferior é habitualmente prescrito antiagregantes plaquetários e a anticoagulação é considerada em casos de risco aumentado de trombose. Realizamos uma revisão sistemática da literatura da evidência existente sobre o uso prolongado de anticoagulantes no pós-operatório de pontagens do membro inferior.
Material e métodos: Revisão sistemática da literatura disponível na base de dados Pubmed.
Resultados: Os estudos selecionados para a revisão final consistiam em: 6 estudos aleatorizados controlados (e 4 análises post-hoc), 1 estudo prospectivo com controlos históricos e 3 estudos retrospectivos.
Conclusão: A eficácia da hipocoagulação depende do conducto utilizado e factores intrínsecos da pontagem. Existe benefício de hipocoagulação nas pontagens com o conduto venoso autólogo mas o nível de INR e os factores de risco para trombose poderão influenciar os resultados. Nas pontagens poderá haver benefício naquelas com calibre diminuído e baixa velocidade média. A incidência de hemorragia major é significativa, sendo essencial a cuidadosa avaliação do risco beneficio na prescrição de hipocoagulação crónica.
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