Balancing Bleeding and Clotting Risks: Updated LP Guidelines in Antithrombotic Care- by Dr. Chokri Ben Lamines
Updated Peri-Procedural Guidelines at a Glance on X։
Explore Dr. Chokri Ben Lamine’s evidence-based guide on safely performing lumbar puncture in patients receiving anticoagulants or antiplatelet therapy. This concise reference outlines when to pause, bridge, or proceed—based on the latest international recommendations․
“Lumbar Puncture & Bleeding Risk: Summary
-When to stop or continue common agents (aspirin, warfarin, DOACs)
-Risk stratification for bleeding vs. thrombosis
-Bridging protocols for high-risk patients
-Practical timing for safe LP executionStop Antithrombotics Before LP
Antiplatelets
• Aspirin 75mg: Continue
• Clopidogrel: 7d (aspirin cover) → LP after 6h
• Prasugrel/Ticagrelor: 7d → LP after 6h
• Dipyridamole: 24h → LP after 6h
• Tirofiban/Eptifibatide: 4–8h → LP after 4h
• Abciximab: 48h → LP after 24hAnticoagulants
• Warfarin: 5d → INR ≤1.4 → LP → restart 12h
• LMWH (proph): 12h → LP → restart 4h
• LMWH (Tx): 24h → LP → restart 4h (24h if traumatic)
• Fondaparinux (proph): 36h → LP → restart 6–12h
• Fondaparinux (Tx): Avoid LP
• UFH IV: –6h → LP → restart 1h
• Rivaroxaban/Apixaban: 24h → LP → restart 6h
• Dabigatran: 48h → LP → restart 6h”
For fast answers to nuanced clinical questions, visit Hemostasis Today.
-
Feb 3, 2026, 17:18Khalid Ahmed: The HALO Study to Understand Quality of Life After Childhood Hematological Disorders
-
Feb 3, 2026, 17:09Mahesan Subramaniam: The Impact of Chronic Financial Stress and Instability on Cardiovascular Health
-
Feb 3, 2026, 17:01Sunisha A: Deep Vein Thrombosis – A Silent but Serious Threat
-
Feb 3, 2026, 16:56Vicklen Pesiwarissa: Upper Extremity Deep Vein Thrombosis as a Cause of Pulmonary Embolism
-
Feb 3, 2026, 16:52Hope, Independence and Dignity for People with Bleeding Disorders Through the WFH Humanitarian Aid Program
-
Feb 3, 2026, 16:34Join the EHC Round Table on Extremely Rare Bleeding Disorders
-
Feb 3, 2026, 16:30Robert Weber: The ‘Bone Marrow Hack’ – Releasing Stem Cells Using Light, Not Needles
-
Feb 3, 2026, 16:23Scott Kinlay։ Cancer and Adverse Outcomes Over 5 Years After Coronary Stenting and Optimal DAPT Duration
-
Feb 3, 2026, 16:05Abhishek Paserkar։ Revolutionizing Hypertriglyceridemia Treatment With Olezarsen