Comprehensive review of anticoagulants, their pharmacology and uses, and appropriate reversal agents

Monday, March 6, 2023

5:05 PM – 5:10 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

FR

Faezeh Razjouyan, MS, MD

Fellow
Hospital

Disclosure(s): No financial relationships to disclose

Disclosure(s):

Faezeh Razjouyan, MS, MD: No financial relationships to disclose

Learning Objectives: The objective of this educational poster is to give a comprehensive and simple review of the spectrum of current and commonly used anticoagulants, their pharmacology, appropriate uses, and reversal agents. It is essential for all interventional radiologists to be familiar with intra-procedure anticoagulants and understand the appropriate use to optimize management of patients before and after procedures to minimize risk of procedure-related complications.

Background: Anticoagulants have been the cornerstone therapy for thrombus prevention and treatment. Advances in venous thromboembolism have resulted in a complex assortment of available anticoagulation. Therefore, interventional radiologists must be familiar with these different anticoagulation regimens, the pathophysiology, pharmacodynamics, and toxicity and have a clear understanding of when and how to use the available anticoagulants.

Clinical Findings/Procedure Details: The coagulation cascade is incited by trauma and/or vascular insult. Thrombin is one of the most potent activators of platelet mediated and clotting factor mediated hemostasis. Thrombin can also incite thrombogenesis by fibrin polymerization, platelet receptor activation, and endothelium activation. Anticoagulant agents will inhibit thrombogenesis by altering the clotting cascade. Alternatively, some of the newer agents, indirect inhibitors, will bind to plasma cofactors and catalyze the interaction with clotting enzymes.

Conclusion and/or Teaching Points: This educational poster aims to summarize salient points on currently available anticoagulants, their mechanism of action as well as the role of reversal agents in management of periprocedureal bleeding based on extrapolation of the available data in the medical and pharmacologic literature. While much of this may be common knowledge, there is a large gap of knowledge in the community regarding many of the newer anticoagulants and their appropriate use.