====== Anticoagulant ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1RqsD81NqAC33mD1TRWT4ULBC7mQiSj3HbJIGsywYV13GnWoyQ/?limit=15&utm_campaign=pubmed-2&fc=20241112130443}}
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Anticoagulants are a class of drugs that work to prevent the [[coagulation]] (clotting) of [[blood]]. 

Such substances occur naturally in leeches and blood-sucking insects. A group of pharmaceuticals called anticoagulants can be used as an injection into human beings as a medication for thrombotic disorders. 

[[Oral anticoagulant]]s are also available. Some anticoagulants are used in medical equipment, such as test tubes, blood transfusion bags, and renal dialysis equipment.

A comprehensive knowledge of novel anticoagulants is an important part of current neurosurgical practice. While [[warfarin]], [[heparin]] and its low molecular weight derivative, [[enoxaparin]], have formed the mainstay of treatment for atrial fibrillation, valvular heart disease and the prevention of venous thromboembolism for over 30 years
((Verma AK. Dabigatran etexilate: A new thrombin inhibitor. Med J Aust. 2010;192:407–12.))
, new agents have recently been approved that promise to revolutionize the treatment of these conditions. There are compelling medical reasons driving the adoption of these agents and they will have an important impact on neurosurgical practice
((Dwyer CM, Damodaran O, Heckelmann M, Sheridan MM. What neurosurgeons need to
know about dabigatran etexilate (pradax(®)/pradaxa(®)/prazaxa(®). Asian J
Neurosurg. 2015 Apr-Jun;10(2):66-8. doi: 10.4103/1793-5482.144156. PubMed PMID:
25972932; PubMed Central PMCID: PMC4421970.
)).

===== Heparin =====


see [[Heparin]].

===== Direct Oral anticoagulant =====


see [[Direct Oral anticoagulant]].
===== Indications =====

Perioperative [[anticoagulant]] prophylaxis for postoperative [[venous thromboembolism]] (VTE) in neurosurgical patients has not gained wide acceptance due to the fear of intracranial bleeding. Physical methods give a worthwhile reduction of postoperative VTE but there still remains a substantial residual incidence. In other clinical indications, low molecular weight heparins have proven to be effective for prophylaxis of VTE when administered postoperatively, with the advantage of no bleeding enhancement during surgery.
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Anticoagulation after [[ischemic stroke]] was a topic of major controversy for decades until a series of [[Randomized controlled trial]]s consistently showed no net benefit of [[heparin]] or [[warfarin]] compared with [[aspirin]]
((PA Sandercock, C Counsell, AK Kamal Anticoagulants for acute ischaemic stroke Cochrane Database Syst Rev (2008) CD000024.))
((PA Sandercock, LM Gibson, M Liu Anticoagulants for preventing recurrence following presumed non-cardioembolic ischaemic stroke or transient ischaemic attack Cochrane Database Syst Rev (2009) CD000248.)).

see [[Anticoagulation in glioblastoma]].

====Complications====
see [[Intracranial hemorrhage and anticoagulation]].
===== Resumption =====

[[Anticoagulation Resumption]].