A 72-year-old with nonvalvular AF (CHA₂DS₂-VASc 3) on apixaban needs elective cancer surgery with high bleeding risk. CrCl 70 mL/min. Best periprocedu...

Question

A 72-year-old with nonvalvular AF (CHA₂DS₂-VASc 3) on apixaban needs elective cancer surgery with high bleeding risk. CrCl 70 mL/min. Best periprocedural plan?

Accepted Answer

Stop apixaban 2 days before; no heparin bridging

Answer

Stop apixaban morning of surgery; bridge with LMWH

Answer

Continue apixaban through surgery

Answer

Switch to warfarin 1 week prior with INR 2-3

Answer

Hold apixaban 5 days; bridge with UFH

us-abim MCQ (SBA): Perioperative Anticoagulation

A 72-year-old with nonvalvular AF (CHA₂DS₂-VASc 3) on apixaban needs elective cancer surgery with high bleeding risk. CrCl 70 mL/min. Best periprocedural plan?