A 49-year-old man with nonvalvular atrial fibrillation on apixaban for stroke prevention is scheduled for an elective colectomy with high bleeding ris...

Question

A 49-year-old man with nonvalvular atrial fibrillation on apixaban for stroke prevention is scheduled for an elective colectomy with high bleeding risk. His creatinine is normal. What is the most appropriate perioperative management of his anticoagulation?

Accepted Answer

Switch from apixaban to therapeutic IV heparin until 6 hours pre-op

Answer

Continue apixaban through the day of surgery

Answer

Stop apixaban 24 hours before surgery with no bridging

Answer

Stop apixaban 48 hours before surgery with no bridging

Answer

Stop apixaban 5 days before surgery and start aspirin instead

us-abim MCQ (SBA): Perioperative Anticoagulation Management

A 49-year-old man with nonvalvular atrial fibrillation on apixaban for stroke prevention is scheduled for an elective colectomy with high bleeding risk. His creatinine is normal. What is the most appropriate perioperative management of his anticoagulation?