Expert discusses aspirin continuation in patients undergoing PCNL

In this video, Smita De, MD, PhD, shares the take-home message 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:

What is the take-home message for the practicing urologist?

I think that overall, one should do what one is comfortable with, within the scope of your practice and your resources. If a patient does require a PCNL, and that is something that you are comfortable doing, and that patient does need to stay on their aspirin, especially low-dose aspirin—which was the majority of the cohort in our study—there doesn't appear to be an increased risk of bleeding complications. Again, I want to point out [that] this is not a randomized trial, which, of course, would provide the highest level of evidence for that.

Is there anything you would like to add?

Over the past few years, since we started this study, there's been a rapid increase in the use of mini PCNL and all the other miniaturization type of techniques and instrumentation. I would suspect that now there's an even more decreased risk of bleeding overall, and certainly then in these patients who require continuation of their aspirin, I think we can be even more comfortable with proceeding on those patients.

This transcription was edited for clarity.