A 72-year-old with persistent AF is referred for colonoscopy with polypectomy (high bleeding risk). On warfarin with CHADS₂VASc 5 and no prior stroke....

Question

A 72-year-old with persistent AF is referred for colonoscopy with polypectomy (high bleeding risk). On warfarin with CHADS₂VASc 5 and no prior stroke. Recommended perioperative anticoagulation?

Accepted Answer

Stop warfarin ~5 days prior; avoid routine bridging unless very high thrombotic risk; resume when hemostasis achieved

Answer

Continue warfarin at INR 2-3

Answer

Bridge all AF patients with LMWH

Answer

Hold warfarin on the day only

Answer

Switch to DOAC 48 hours prior

us-abim MCQ (SBA): Warfarin Bridging Strategy

A 72-year-old with persistent AF is referred for colonoscopy with polypectomy (high bleeding risk). On warfarin with CHADS₂VASc 5 and no prior stroke. Recommended perioperative anticoagulation?