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Insertion of venous access devices is usually considered a procedure with low risk of bleeding.
Nonetheless, especially in patients with previous coagulopathy or in treatment with antithrombotic drugs for cardiovascular disease, this procedure may be invasive enough to be associated with bleeding.
The GAVeCeLT has developed a consensus on the management of antithrombotic treatment and bleeding disorders in patients requiring a VAD. Let's see, below, more details.
The GAVeCeLT consensus came about for several reasons. First, it must be considered that current practices of platelet/plasma transfusion in coagulopathic patients - and of temporary suspension of the antithrombotic treatment before VAD insertion - are often inadequately supported by evidence.
In fact, many of the clinical studies on this topic are not recent and are not of high quality. Moreover, especially after the introduction of new oral anticoagulant drugs, the protocols of antithrombotic treatment have changed during the last decade. And although there are guidelines that address some of these issues in specific procedures (e.g., port insertion, etc.), no evidence-based document covering all the aspects of this clinical problem is currently available.
So, the consensus working group included vascular access specialists, surgeons, intensivists, anesthetists, cardiologists, vascular medicine experts, nephrologists, infective disease specialists, and thrombotic disease specialists. After a systematic review of the available evidence, they structured the final recommendations as answers to 3 macro-questions, namely:
1. which is an appropriate classification of VAD-related procedures based on the specific bleeding risk?
2. which is the appropriate management of the patient with bleeding disorders candidate to VAD insertion/removal?
3. which is the appropriate management of the patient on antithrombotic treatment candidate to VAD insertion/removal?
Only statements reaching a complete agreement were included in the final recommendations, and all recommendations were offered in a clear and synthetic list, so to be easily translated into clinical practice.
You can consult, in detail, the GAVeCeLT consensus at this link.
Delta Med's central and peripheral venous catheters are entirely made-in-Italy devices designed and manufactured for the safety of patients and healthcare professionals.
All our vascular access devices are produced to simplify procedures for doctors and nurses, avoid human error and reduce the risk of infections and complications.
Several solutions are available in the Delta Med catalog, which can be configured and customized as needed. For example: