Recently, a direct oral anticoagulants (DOACs) has been developed and prescribed widely to replaces warfarin. The aim of this survey was to investigate the outcome of invasive treatment administered in accordance with existing guidelines in our department in patients receiving DOACs
From April 2015 to December 2016, we examined 15 patients who were receiving DOACs and underwent oral surgery at Suidoubashi Hospital of Tokyo Dental College and invasive treatment as outpatients. The survey items, including gender, age, original disease, DOAC type, CHADs2 score, presence or absence of past history of cerebral infarction, treatment modalities, reasons for treatment, treatment content, presence or absence of drug withdrawal and post-bleeding treatment, the treatment duration, and local hemostasis method, were investigated retrospectively from reviewing patient’s medical records.
The study included 10 men and 5 women, with a mean age of 72.0 years. The type of DOAC was dabigatran in 3 cases, riveroxaban in 10 cases, and apixaban in 2 cases. The treatment content was tooth extraction (simple and surgical tooth extractions), tooth extraction and cystectomy, and tumor resection. Thirteen patients continued to receive DOACs, and two patients chose drug withdrawal before treatment. Three cases required additional treatment due to bleeding. In one case, a combination of topical hemostatic agent and surgical plate was used for local hemostasis.
No serious complications, such as embolic disease, occurred in 15 patients. This survey results suggest that invasive treatment in patients who receiving DOACs in accordance with guidelines could lead to adequate local hemostasis.
