Question

A 64-year-old on apixaban 5 mg BID for AF is scheduled for an elective colon cancer resection (high bleeding risk). Creatinine clearance 70 mL/min. How should apixaban be managed perioperatively?

Accepted Answer

Hold apixaban for 48 hours before surgery; no bridging

Answer

Continue apixaban through surgery

Answer

Hold apixaban for 24 hours before surgery; bridge with LMWH

Answer

Switch to warfarin 7 days prior

Answer

Administer vitamin K 48 hours prior

Practice question

A 64-year-old on apixaban 5 mg BID for AF is scheduled for an elective colon cancer resection (high bleeding risk). Creatinine clearance 70 mL/min. How should apixaban be managed perioperatively?