A patient takes rivaroxaban 20 mg each evening for previous VTE. Renal function is normal and elective hip arthroplasty with neuraxial anaesthesia is ...

Question

A patient takes rivaroxaban 20 mg each evening for previous VTE. Renal function is normal and elective hip arthroplasty with neuraxial anaesthesia is planned. Thrombotic risk is not exceptional. Which perioperative strategy is appropriate?

Accepted Answer

Interrupt rivaroxaban without routine LMWH bridging

Answer

Continue rivaroxaban through surgery with anti-Xa monitoring

Answer

Interrupt rivaroxaban for 12 hours and give therapeutic LMWH

Answer

Replace rivaroxaban with warfarin one week before surgery

Answer

Stop rivaroxaban permanently and use aspirin after surgery

Perioperative Anticoagulation (DOAC) — MRCP Part 1 MCQ

A patient takes rivaroxaban 20 mg each evening for previous VTE. Renal function is normal and elective hip arthroplasty with neuraxial anaesthesia is planned. Thrombotic risk is not exceptional. Which perioperative strategy is appropriate?