A 72-year-old on apixaban 5 mg BID with normal renal function is scheduled for elective colectomy (high bleeding risk). Perioperative DOAC plan?...

Question

A 72-year-old on apixaban 5 mg BID with normal renal function is scheduled for elective colectomy (high bleeding risk). Perioperative DOAC plan?

Accepted Answer

Hold apixaban for ~48 hours before surgery without bridging

Answer

Continue apixaban through surgery

Answer

Hold apixaban for 24 hours pre-op only

Answer

Bridge with therapeutic LMWH and continue apixaban

Answer

Switch to warfarin 5 days pre-op

us-abim MCQ (SBA): Perioperative Anticoagulation