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September 11, 2025Research and Practice in Thrombosis and Haemostasis1 citationsOpen Access

Optimizing care for patients after major anticoagulant-related bleeding: a narrative review and proposal for a clinical care pathway

JKJurjen F. KrommenhoekECEleonora CamilleriTMThijs E. van Mens

Key Result

A proposed clinical care pathway for survivors of anticoagulant-related major bleeding addresses uncertainties in optimal aftercare, including the timing of anticoagulation resumption.

Structured PICO

P
Population
Patients surviving major anticoagulant-related bleeding
I
Intervention
Dedicated clinical care pathway and aftercare strategies (including resumption of anticoagulation, risk factor modification, and patient-reported outcomes)

This narrative review proposes a dedicated clinical care pathway to optimize aftercare and guide the resumption of anticoagulation for patients surviving major anticoagulant-related bleeding.

Abstract

Oral anticoagulation, although effective for the treatment and prevention of thromboembolic events, increases the risk of major bleeding. The acute management phase of anticoagulant-related major bleeding requires rapid decision-making and often involves multiple medical specialties. Guidelines offer some guidance for the acute management phase, most notably on strategies for anticoagulant reversal, but there are still uncertainties about how to organize optimal aftercare. In this narrative review, we examine the different aspects of aftercare from both clinicians' and patients' perspectives, including the resumption of anticoagulation, its timing, risk factor modification, and patient-reported outcomes. Finally, we present a dedicated clinical care pathway for survivors with anticoagulant-related major bleeding.

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Cite This Study

Krommenhoek et al. (2025) conducted a review in Anticoagulant-related major bleeding. Clinical care pathway was evaluated. A proposed clinical care pathway for survivors of anticoagulant-related major bleeding addresses uncertainties in optimal aftercare, including the timing of anticoagulation resumption.

synapsesocial.com/papers/6a5f2c2c531077db68af3968https://doi.org/10.1016/j.rpth.2025.103183
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