Perioperative Anticoagulation Algorithm

SCHS Anticoagulation Guidelines 1 Perioperative Anticoagulation GUIDELINE/DOAC MANAGEMENT Options for Anticoagulation continue to expand with the use of direct oral anticoagulants (DOACs). While the thromboembolic risk is determined by the patient s condition, the Perioperative management of DOACs is vastly different and varied. Bridging is not recommended with DOACs. DOAC Patient is Taking Surgery Bleeding Risk Preoperative DOAC Interruption Schedule Postoperative DOAC Resumption Schedule Day -5 Day -4 Day -3 Day -2 Day -1 Day +1 Day + 2 Day +3 Day +4 Apixaban (Eliquis) Mod/High X X X Low X Dabigatran (CrCl>50ml/min) Mod/High X X X Low X Dabigatran (CrCl<50ml/min) Mod/High X X X X X Low X X Rivaroxaba

Prostatectomy or bladder surgery Renal biopsy, bowel polypectomy Low risk of post op thrombosis Bileaflet Aortic Valve without stroke On-X valve Atrial fibrillation and no risks factors3 Resume warfarin 12-24 hours post procedure at usual dose (no bridging therapy) once hemostasis achieved Resume warfarin 3-7 days post procedure at usual

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