Expert Recommendations on the Usage of Non-vitamin K Antagonist Oral Anticoagulants (NOACs) from India: Current Perspective and Future Direction.

Non-vitamin K antagonist oral anticoagulants (NOACs) are a new class of anticoagulant drugs used in the prevention and treatment of venous thromboembolism (VTE) and atrial fibrillation (AF). Anticoagulation requires the integration of the correct type and dose of oral anticoagulants based on patient characteristic, and therefore therapy needs to be individualized for each patient. Growing scientific evidence from studies on NOACs has led to a better understanding of their benefits and safety. A large amount of available data creates a necessity for an adaptable practical document for the usage of NOACs in India. The current consensus, developed by experts from India, aims to give recommendations on various frequently raised clinical questions with regards to NOACs and its usage. This practical document provides a platform upon which future guidelines, policies, training, and education for the use of NOACs can be tailored.

Acute thrombotic occlusion after total knee arthroplasty: Role of endovascular management.

AIM: Acute arterial occlusions after total knee arthroplasty (TKA) are rare but very serious complication. We present a series of 9 patients who underwent endovascular recanalisation for acute thrombotic occlusion following TKA in our institution. The present series determine the importance of early diagnosis and role of early intervention for good clinical outcome in these cases. METHODS: From 2013 to 2016, a total of 9 patients (3 male and 6 female) presented with acute popliteal thrombosis following TKA. All the patients underwent endovascular procedure. Clinical presentation, procedural details and clinical outcome was discussed. RESULTS: Technical success is achieved in all the cases. A combination of clot lysis, thromboaspiration and balloon angioplasty was used. 8 patients had successful clinical outcome. One patient underwent amputation despite good recanalisation. CONCLUSION: High degree suspicion with careful monitoring in the postoperative period is needed to identify the problem at the earliest, and early diagnosis with recanalisation within 6 h is the key to limb salvage in these patients.