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<p>Perioperative management of antithrombotic therapy remains a&#xa0;clinical challenge, particularly in patients with elevated thromboembolic and/or bleeding risk. This article provides a&#xa0;structured and practice-oriented summary of current recommendations for the management of oral anticoagulants—including vitamin&#xa0;K antagonists and direct oral anticoagulants—as well as antiplatelet agents such as acetylsalicylic acid, clopidogrel, prasugrel, and ticagrelor in surgical and interventional settings. Key clinical strategies are outlined, including the indications for bridging therapy, timing of treatment interruption before procedures, and safe resumption of antithrombotic medications. Special emphasis is placed on high-risk populations, such as patients with renal insufficiency, diabetes mellitus, or recent stent implantation, as well as those requiring dual antiplatelet therapy. Guidance is based on current international recommendations and clinical experience, with the aim of helping physicians avoid perioperative complications and enhance patient safety. Particular focus is placed on individual risk stratification, interprofessional coordination, and the application of risk-adapted treatment pathways.</p>

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Perioperatives Management von Menschen mit Diabetes mellitus: Antikoagulation und Plättchenfunktionshemmung

  • 期刊论文

  • 发表日期：

    2026年2月20日

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  • Christoph Sucker,
  • Bartosz Zawislak,
  • Jürgen Koscielny

摘要

Perioperative management of antithrombotic therapy remains a clinical challenge, particularly in patients with elevated thromboembolic and/or bleeding risk. This article provides a structured and practice-oriented summary of current recommendations for the management of oral anticoagulants—including vitamin K antagonists and direct oral anticoagulants—as well as antiplatelet agents such as acetylsalicylic acid, clopidogrel, prasugrel, and ticagrelor in surgical and interventional settings. Key clinical strategies are outlined, including the indications for bridging therapy, timing of treatment interruption before procedures, and safe resumption of antithrombotic medications. Special emphasis is placed on high-risk populations, such as patients with renal insufficiency, diabetes mellitus, or recent stent implantation, as well as those requiring dual antiplatelet therapy. Guidance is based on current international recommendations and clinical experience, with the aim of helping physicians avoid perioperative complications and enhance patient safety. Particular focus is placed on individual risk stratification, interprofessional coordination, and the application of risk-adapted treatment pathways.