{"id":"2e4294f6-af0b-4407-8b93-4d040d96f1b7","slug":"antithrombotic-management-in-magnetic-resonance-guided-focused-ultrasound-should-these-therapies-be-discontinued","title":"Antithrombotic management in magnetic resonance-guided focused ultrasound: Should these therapies be discontinued?","authors":["Jorge Cabrera-Montes","José-Ángel Cabrera"],"abstract":"Background: The management of antithrombotic therapies poses significant challenges in neurosurgery due to their potential to increase hemorrhagic complications. Recent advancements in functional neurosurgery, particularly magnetic resonance-guided focused ultrasound (MRgFUS), have raised questions about the management of anticoagulation and antiplatelet therapy in patients undergoing these procedures. Current guidelines suggest that the use of these medications may be an exclusion criterion for MRgFUS, yet evidence supporting this is limited. Summary: This letter highlights the lack of consensus regarding the management of antithrombotic therapies in the context of MRgFUS, particularly for patients with high thrombotic risk. While some studies indicate that MRgFUS may be safe with continued antithrombotic therapy, the decision-making process remains complex and individualized. A multidisciplinary approach is suggested to assess risks and benefits on a case-by-case basis, potentially incorporating digital tools for risk stratification. Conclusion: The absence of robust clinical evidence necessitates further research, including prospective trials, to clarify the safety of maintaining versus interrupting antithrombotic therapy during MRgFUS. Establishing clear guidelines based on differentiated analysis of anticoagulant and antiplatelet therapies is crucial for advancing clinical practice in this rapidly evolving field. Keywords: antithrombotic, MRgFUS, neurosurgery, hemorrhage, anticoagulation, antiplatelet, guidelines, risk assessment","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/stereotactic.png","publishDate":"2026-03-13T00:00:00.000Z","doi":"10.25259/SNI_1207_2025","categories":["Stereotactic","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/03/14369/SNI-17-144.pdf"}