Hematology Series: Anticoagulation therapies and surgical considerations (with Dr. Andrew Jenzer)

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Mar 17, 2025

Dr. Andrew Jenzer, an oral maxillofacial surgeon from North Carolina with a deep expertise in hematology, shares invaluable insights into anticoagulation therapies. Listeners learn about thrombosis causes, the crucial guidelines like Wells' Criteria, and the complexities of managing pulmonary embolisms. Dr. Jenzer distinguishes between provoked and unprovoked clots while emphasizing perioperative management for patient safety. He also tackles the intricacies of anticoagulation in dental settings, ensuring that healthcare professionals grasp essential life-saving knowledge.

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ADVICE

Heparin Reversal Cautions

Protamine sulfate reverses unfractionated heparin effects but only partially reverses low molecular weight heparins.
Exercise caution due to protamine allergies, especially in patients with fish allergies.

INSIGHT

Warfarin Mechanics and Risks

Warfarin inhibits vitamin K epoxide reductase, affecting vitamin K-dependent clotting factors.
Initial warfarin use creates a transient hypercoagulable phase risking skin necrosis, necessitating bridging anticoagulation therapies.

ADVICE

Effective Warfarin Reversal Options

Reverse warfarin with vitamin K, fresh frozen plasma, or prothrombin complex concentrate (PCC).
PCCs offer faster reversal than plasma and avoid volume overload risks.

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Blood clots can be life-threatening, but understanding their causes and treatments can save lives. In Part 2 of our Hematology Series, Dr. Andrew Jenzer, DDS, dives deep into thrombosis, breaking down the three key contributing factors and the most common hypercoagulable conditions. We carefully dissect the pathophysiology of pulmonary embolisms, the most important guidelines to know and follow, the difference between provoked and unprovoked hypercoagulable conditions, and everything you need to know about the perioperative management of antithrombotic therapies. To close, Dr. Jenzer highlights the critical risk factors of preoperative anticoagulation and key takeaways from our conversation that should never be forgotten. If you're a healthcare professional or simply someone who values life-saving knowledge, this episode is packed with insights you won't want to miss. Tune in to sharpen your expertise and improve patient outcomes!

Key Points From This Episode:

Three contributors to thrombosis and the most common hypercoagulable conditions.
Unpacking the pathophysiology of pulmonary embolisms.
Wells’ Criteria, CHEST, and other crucial guidelines to follow.
The difference between provoked and unprovoked hypercoagulable conditions.
Anticoagulation therapies and important surgical considerations.
Risk factors associated with the perioperative management of antithrombotic therapy.
Recapping the key takeaways from today’s conversation.

Links Mentioned in Today’s Episode:

Dr. Andrew Jenzer Email — andrew.jenzer@gmail.com

Dr. Andrew Jenzer | Duke Surgery — https://surgery.duke.edu/profile/andrew-clark-jenzer

ACOMS | Annual Winter Meeting — https://www.acoms.org/Events/Winter-Meeting/About

Wells' Criteria for Pulmonary Embolism — https://www.mdcalc.com/calc/115/wells-criteria-pulmonary-embolism

Wells' Criteria for DVT — https://www.mdcalc.com/calc/362/wells-criteria-dvt

American College of Chest Physicians — https://www.chestnet.org/

‘Perioperative Management of Antithrombotic Therapy’ — https://www.chestnet.org/guidelines-and-topic-collections/guidelines/pulmonary-vascular/perioperative-management-of-antithrombotic-therapy

‘Perioperative Management of Patients with Atrial Fibrillation Receiving a Direct Oral Anticoagulant’ — https://pubmed.ncbi.nlm.nih.gov/31380891/

‘Perioperative Optimization and Management of the Oral and Maxillofacial Surgical Patient’ — https://pubmed.ncbi.nlm.nih.gov/38103577/

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/

Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/

Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/

Dr. Grant Stucki Email — grantstucki@gmail.com

Dr. Grant Stucki Phone — 720-441-6059