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Periprocedural DOAC (Low Risk) — ESEGH MCQ

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HardHematologyPeriprocedural DOAC (Low Risk)ESEGH

A 62-year-old with atrial fibrillation (CHA₂DS₂-VASc 2) is scheduled for elective colonoscopy without polypectomy. She is currently taking apixaban for thromboembolism prevention. How should apixaban be managed perioperatively?

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Correct answer: A — Omit the morning apixaban dose and resume after haemostasis

The best answer is “Omit the morning apixaban dose and resume after haemostasis”. Stop on the morning of the procedure and resume the following day if hemostasis is confirmed The alternatives “Continue without interruption throughout the perioperative period”, “Hold for 3–5 days before the procedure”, “Bridge with low-molecular-weight heparin (LMWH), when clinically appropriate”, “Switch to warfarin temporarily during the perioperative period” are plausible in related gastroenterology presentations but do not match the defining finding, threshold, sequence or UK pathway in this stem.

Reference: BSG post-polypectomy surveillance guideline: https://gut.bmj.com/content/69/2/201