Dr. Smita De discusses aspirin use in patients undergoing PCNL

In this video, Smita De, MD, PhD, shares the background and notable findings from the recent Urology study “Is it Safe to Continue Aspirin in Patients Undergoing Percutaneous Nephrolithotomy?” De is a staff physician at the Glickman Urological & Kidney Institute at Cleveland Clinic, Cleveland, Ohio and a clinical assistant professor of urology at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

Transcription:

How will these findings affect your clinical practice?

It certainly made me a lot less anxious for those patients who do need to continue their aspirin. Usually, that's going to be our patients who have a strong cardiac history. One of the things you had asked earlier was, were there any surprising findings? This is a retrospective study, so while we can't be sure of why we saw certain things, one of the things we did see is that patients who had a higher BMI were more likely to have their aspirin stopped. We're a little unclear on why that is. Is it because of surgeon preference, because the patient was a little bit more complex in terms of their stone burden? We looked at that, and we actually did not find that to be the case; it was just simply that they had a higher BMI, and so their aspirin was stopped. I think that may have some degree to do with the surgeon's comfort level. I'm not sure if I would make that a point within my own practice, per se. I think, again, we're seeing that it is okay to continue aspirin. Another thing we saw was that in most cases, urologists obtain their own access for PCNL. But in patients who stayed on aspirin, those patients were more likely to have their access obtained by interventional radiology. And again, it's a retrospective study, so we can't exactly say why, but it could be because those patients may have been sicker, so the idea was to reduce their time under general anesthesia. By having interventional radiology obtain access, they may have been able to reduce the amount of time under anesthesia. Those are things I would probably keep in mind for my own patients, but overall, it makes me more comfortable with the idea of continuing aspirin during a PCNL.

This transcription was edited for clarity.