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World J Cardiol. Apr 26, 2024; 16(4): 191-198
Published online Apr 26, 2024. doi: 10.4330/wjc.v16.i4.191
Aspirin interruption before neurosurgical interventions: A controversial problem
Alexander Kulikov, Anton Konovalov, Pier Paolo Pugnaloni, Federico Bilotta
Alexander Kulikov, Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow 125047, Russia
Anton Konovalov, Department of Vascular Neurosurgery, Burdenko National Medical Research Center of Neurosurgery, Moscow 125047, Russia
Pier Paolo Pugnaloni, Federico Bilotta, Department of Anesthesiology, Critical Care and Pain Medicine, University of Rome “Sapienza”, Rome 00161, Italy
Author contributions: Kulikov A, Bilotta F designed the research; Kulikov A, Konovalov A, Pugnaloni PP performed the research; Kulikov A, Konovalov A, Bilotta F analyzed the data and wrote the paper.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Federico Bilotta, MD, PhD, Professor, Department of Anesthesiology, Critical Care and Pain Medicine, University of Rome “Sapienza”, Policlinico Umberto I, Viale del Policlinico 37, Rome 00161, Italy. bilotta@tiscali.it
Received: December 27, 2023
Peer-review started: December 27, 2023
First decision: January 17, 2024
Revised: January 26, 2024
Accepted: February 29, 2024
Article in press: February 29, 2024
Published online: April 26, 2024
Processing time: 118 Days and 1.9 Hours
Core Tip

Core Tip: A decision on continuing or interrupting aspirin use before neurosurgical intervention should be made based on a discussion of specialists involved in perioperative management (neurosurgeon, anesthesiologist, cardiologist, etc), taking into account estimated blood loss; risk of complications associated with increased bleeding time; risk of postoperative ischemic complication associated with aspirin interruption; and risk of surgery postponement.