Key result
Perioperative management of anticoagulation depends on patient-specific thromboembolic and procedural bleeding risks, with much guidance still based on expert consensus.
Why the study?
Periprocedural management of anticoagulated patients involves balancing patient thromboembolic risk and procedural bleeding risk, but much of the clinical guidance remains based on expert consensus.
Periprocedural anticoagulation management depends on patient-specific thromboembolic and procedural bleeding risks, guided by recent studies and expert consensus.
Mandates individualized risk assessment for periprocedural anticoagulation; leaves open stronger randomized evidence to refine consensus guidance.
Periprocedural management of the anticoagulated patient can be as easy as continuing warfarin for a low bleeding risk procedure, holding a direct oral anticoagulant for 1 day prior and resuming 1 day later or as complex as emergent reversal with prothrombin complex concentrate, idarucizumab, or andexanet alfa. Patient-specific factors for thromboembolic risk and procedural bleeding risk determine timing of anticoagulation hold prior to and resumption after invasive procedures. Clinical trials and management studies in recent years have helped inform our approach to these patients, but much of the guidance is still based on expert consensus.
No takes yet. Share an insight, caveat, or question.
Talari et al. (2020) conducted a review in Anticoagulated patients undergoing procedures. Perioperative management of anticoagulation was evaluated. Perioperative management of anticoagulation depends on patient-specific thromboembolic and procedural bleeding risks, with much guidance still based on expert consensus.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:
More on Anticoagulation in AFMore from Hospital Practice