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Duncan Bayne, MRCS, FDSRCS; Peter A. Brennan, MD, FRCS, FRCSI, FDSRCS

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We read with interest the extensive cohort study by Garcia and colleagues¹ and agree that the risks of iatrogenic thromboembolic or hemorrhagic events should be carefully considered before warfarin therapy is stopped or bridged. Their study found that while patients receiving bridging therapy with heparin had an increased risk of bleeding, thromboembolic prophylaxis was maintained.

As oral and maxillofacial surgeons, we were particularly interested to see that nearly 25% of the patient cohort required an oral surgery procedure with interventions made to their warfarin regimen prior to surgery.¹ One patient in the study had a stroke following oral surgery.¹ The evidence base both for thromboembolic events and hemorrhage in patients requiring oral surgery is extensive. Most oral surgeons in the United Kingdom and elsewhere do not change the warfarin regimen prior to surgery.

In a review of 542 dental . . . [Full Text of this Article]

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