Oral surgery procedures in patients on anticoagulants. Preliminary report.

INTRODUCTION Patients who receive oral anticoagulants generally undergo oral surgery procedures, especially teeth extractions. Because the withdrawal of anticoagulant therapy may lead to severe thromboembolic complications, an attempt to perform oral surgery procedures without discontinuation of anticoagulation, based on the published reports, was made. AIM To present our own experience with the maintenance of anticoagulant therapy with oral coumarin-type drugs and/or acetylsalicylic acid in patients with cardiovascular diseases who undergo oral surgical procedures. METHODS The group consisted of 40 patients (12 females and 28 males) aged 39-83 years (mean age 58 years) hospitalised in the 1st Department of Oral and Maxillofacial Surgery in Zabrze from January 2000 to June 2003. The following paper presents the results of the treatment of patients with cardiovascular diseases, who are on oral coumarin-type anticoagulants and/or acetylsalicylic acid, performed without modification of the treatment/anticoagulant therapy. RESULTS The level of anticoagulation defined as the INR (International Normalized Ratio) and measured in all patients on the day of surgery ranged from 1.0 to 4.0. Activated Partial Thromboplastin Time (aPTT) was between 26 and 88 seconds, with a reference range in healthy subjects of 42-65 seconds. The prothrombin time ratio ranged from 26% to 100% (N: 80-120%). Only 8% of patients developed minor bleeding complications which were promptly controlled with additional haemostasis. CONCLUSIONS Teeth extractions and other oral surgical procedures may be performed without discontinuation of anticoagulants.