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Figure 4.; §“High-risk” coronary artery aneurysms (CAAs): Other experts may consider additional high-risk features, such as long length and distal location of aneurysms, large total number of CAAs, multiple branches affected, luminal irregularities, vessel wall abnormalities (calcification, luminal thrombosis, previous myocardial infarction, and ventricular dysfunction).10 £Low-dose aspirin: 3–5 mg/kg once daily).
Sarah Lee,
 David B. Guthrie, and
 Ralph H. Epstein
Figure 4.
Figure 4.

§“High-risk” coronary artery aneurysms (CAAs): Other experts may consider additional high-risk features, such as long length and distal location of aneurysms, large total number of CAAs, multiple branches affected, luminal irregularities, vessel wall abnormalities (calcification, luminal thrombosis, previous myocardial infarction, and ventricular dysfunction). 10 £Low-dose aspirin: 3–5 mg/kg once daily).

Cardiovascular Considerations in Anesthetic Management for a Patient With Antiphospholipid Syndrome and Decreased Cardiac Function: A Case Study
Makiko Shibuya DDS, PhD,
 Yukifumi Kimura DDS, PhD,
 Shigeru Takuma DDS, PhD,
 Nobuhito Kamekura DDS, PhD, and
 Toshiaki Fujisawa DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-67-03-07
Page Range: 33 – 37

Antiphospholipid syndrome (APS) is a rare systemic autoimmune disorder characterized by recurrent venous or arterial thrombosis and/or pregnancy morbidity due to the persistent presence of antiphospholipid antibodies that primarily target prothrombin and beta-2 glycoprotein I. APS is classified into 2 groups: primary and secondary depending on the absence or presence of another autoimmune disorder such as systemic lupus erythematosus, respectively. Deep vein thrombosis of the lower extremities is most common in cases of venous thrombus, 1

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Kawasaki Disease and General Anesthesia for Dental Treatment: A Case Report
Sarah Lee DDS,
 David B. Guthrie DMD, and
 Ralph H. Epstein DDS
Article Category: Case Report
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
DOI: 10.2344/anpr-68-01-06
Page Range: 146 – 153

he was admitted for treatment with IVIG, aspirin, and enoxaparin. His acute illness resolved without further complications. Repeated transthoracic echocardiogram over the next several months demonstrated a giant tubular aneurysm of the right coronary artery (RCA) measuring 10 mm in maximal diameter ( Z score 18.7) and a smaller aneurysm of the left anterior descending artery (LAD) measuring 4 mm maximal diameter ( Z score 4.3) ( Figures 1 and 2 , respectively; see discussion for explanation of the Z score). Due to the high risk of thrombosis, the patient was

Figure 1.; Transthoracic echocardiogram image demonstrating patient's giant tubular aneurysm of the right coronary artery (RCA) measuring 10.04 mm maximal diameter; Z score 18.7 (red arrow).
Sarah Lee,
 David B. Guthrie, and
 Ralph H. Epstein
Figure 1.
Figure 1.

Transthoracic echocardiogram image demonstrating patient's giant tubular aneurysm of the right coronary artery (RCA) measuring 10.04 mm maximal diameter; Z score 18.7 (red arrow).

Figure 2.; Transthoracic echocardiogram image demonstrating patient's aneurysm of the left anterior descending artery (LAD) measuring 4.29 mm maximal diameter; Z score 4.3 (red arrow).
Sarah Lee,
 David B. Guthrie, and
 Ralph H. Epstein
Figure 2.
Figure 2.

Transthoracic echocardiogram image demonstrating patient's aneurysm of the left anterior descending artery (LAD) measuring 4.29 mm maximal diameter; Z score 4.3 (red arrow).

Figure 3.; Patient's vitals recorded throughout the procedure in 3-minute increments. See legend on top right corner.
Sarah Lee,
 David B. Guthrie, and
 Ralph H. Epstein
Figure 3.
Figure 3.

Patient's vitals recorded throughout the procedure in 3-minute increments. See legend on top right corner.

Caution: Maintain Anti-Platelet Therapy in Patients with Coronary Artery Stents
Joel M. Weaver DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 54: Issue 4
Online Publication Date: Jan 01, 2007
DOI: 10.2344/0003-3006(2007)54[161:CMATIP]2.0.CO;2
Page Range: 161 – 162

A recent science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and the American Dental Association with representation of the American College of Physicians states that coronary artery stent thrombosis is a very serious problem. * Their new advisory states that dual antiplatelet therapy consisting of aspirin and a thienopyridine drug such as clopidogrel (Plavix) or ticlopidine (Ticlid) should be given for at least a full

Cerebrovascular Accident Under Anesthesia During Dental Surgery
Mathew Cooke DDS, MD, MPH,
 Michael A. Cuddy DMD,
 Brad Farr DDS, and
 Paul A. Moore DMD, PhD, MPH
Article Category: Other
Volume/Issue: Volume 61: Issue 2
Online Publication Date: Jan 01, 2014
DOI: 10.2344/0003-3006-61.2.73
Page Range: 73 – 77

Cardiovascular Drugs: Implications for Dental Practice Part 2—Antihyperlipidemics and Antithrombotics
Daniel E. Becker DDS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 2
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006(2008)55[49:CDIFDP]2.0.CO;2
Page Range: 49 – 56

preventing activation of platelet GP 11b/111a receptors or by blocking the binding sites on receptors that have been activated. These mechanisms are illustrated and summarized in Figure 2 and Table 2 . These varied mechanisms provide a basis for combining agents in order to inhibit platelet aggregation. For example, the combination of aspirin and clopidogrel (Plavix) is more effective than either agent alone for preventing thrombosis following coronary stent placement. Agents that block the GP 11b/111a receptors impart the most “absolute” inhibition of aggregation and

Antithrombotic Drugs: Pharmacology and Implications for Dental Practice
Daniel E. Becker DDS
Article Category: Other
Volume/Issue: Volume 60: Issue 2
Online Publication Date: Jan 01, 2013
DOI: 10.2344/0003-3006-60.2.72
Page Range: 72 – 80

. Heparin can be administered subcutaneously or intravenously, as either an intermittent bolus or continuous infusion. Other than hemorrhage from its anticoagulant influence, the principal side effect attributed to short-term use of heparin is heparin-induced thrombocytopenia. 1 , 3 This is attributed to an immune-mediated reaction whereby antibodies are generated against a complex formed by heparin and a platelet product called platelet factor 4. Before platelet numbers actually decline, arterial thrombosis is common because the antibodies initially trigger existing