Hemorrhagic Complications of Direct Thrombin Inhibitors Subarachnoid Hemorrhage During Dermabrasion for Scar Revision
Dabigatran etexilate is an oral anticoagulant that functions by direct thrombin inhibition. Dabigatran is indicated for atrial fibrillation and stroke prophylaxis, but in the event of hemorrhage, no proven reversal agent exists. As many as 25 38% of patients who present for cutaneous surgery are taking an antithrombotic agent. Current recommendations are to continue medically necessary aspirin, warfarin, and clopidogrel, but the direct thrombin inhibitors have yet to be studied. Familiarity with the new oral anticoagulants is critical so that optimal outcomes can be ensured and complications avoided. The authors report a case of an elderly patient being treated with dabigatran for atrial fibrillation who developed a subarachnoid hemorrhage (SAH) during dermabrasion for scar revision.
Dermatologic surgery official publication for American Society for Dermatologic Surgery [et al.