Complications With New Oral Anticoagulants Dabigatran and Rivaroxaban in Cutaneous Surgery.

Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 9504371 Publication Model: Print Cited Medium: Internet ISSN: 1524-4725 (Electronic) Linking ISSN: 10760512 NLM ISO Abbreviation: Dermatol Surg Subsets: MEDLINE

Publication: 2021- : [Philadelphia] : Wolters Kluwer Health
Original Publication: New York, NY : Elsevier Science, c1995-

Dermatologic Surgical Procedures*; Antithrombins/*adverse effects ; Benzimidazoles/*adverse effects ; Factor Xa Inhibitors/*adverse effects ; Hemorrhage/*chemically induced ; Morpholines/*adverse effects ; Skin Diseases/*surgery ; Thiophenes/*adverse effects ; beta-Alanine/*analogs & derivatives; Administration, Oral ; Aged ; Antithrombins/administration & dosage ; Benzimidazoles/administration & dosage ; Dabigatran ; Factor Xa Inhibitors/administration & dosage ; Female ; Hemorrhage/epidemiology ; Humans ; Male ; Minnesota/epidemiology ; Mohs Surgery ; Morpholines/administration & dosage ; Retrospective Studies ; Risk Factors ; Rivaroxaban ; Thiophenes/administration & dosage ; beta-Alanine/administration & dosage ; beta-Alanine/adverse effects

Background: Anticoagulant medications to date are not associated with increased risk of severe life-threatening complications during cutaneous surgery. Dabigatran and rivaroxaban are new orally administered anticoagulants that do not require laboratory monitoring and have no available specific antidotes, making perioperative management more complex. To the authors' knowledge, published data on the use of dabigatran or rivaroxaban in patients undergoing cutaneous surgery are limited.
Objective: The authors sought to study perioperative complications associated with dabigatran and rivaroxaban during cutaneous surgery.
Materials and Methods: Retrospective chart analysis was performed for all patients who underwent Mohs micrographic surgery or basic excision while taking dabigatran or rivaroxaban between January 1, 2010, and September 1, 2013, at Mayo Clinic, Rochester, MN.
Results: Twenty-seven patients taking dabigatran underwent 41 cutaneous surgeries, with only 1 mild bleeding complication observed that was remedied with a pressure dressing. Four patients on rivaroxaban underwent 5 cutaneous surgeries without complication.
Conclusion: Because no patients on dabigatran or rivaroxaban experienced severe hemorrhagic complications during cutaneous surgery, a strategy of continuing these medically necessary medications during cutaneous surgery seems reasonable.

Comment in: Dermatol Surg. 2017 Apr;43(4):597-599. (PMID: 27984326)

0 (Antithrombins)
0 (Benzimidazoles)
0 (Factor Xa Inhibitors)
0 (Morpholines)
0 (Thiophenes)
11P2JDE17B (beta-Alanine)
9NDF7JZ4M3 (Rivaroxaban)
I0VM4M70GC (Dabigatran)

Date Created: 20150610 Date Completed: 20150901 Latest Revision: 20171010

20231215

10.1097/DSS.0000000000000392

26057410