Question

A 68-year-old man with non-valvular atrial fibrillation on apixaban presents with a planned elective colonoscopy with possible polypectomy. He has normal renal function and CHADS₂-VASc score of 3. According to peri-procedural anticoagulation principles, what is the most appropriate management of apixaban?

Accepted Answer

Stop apixaban 1-2 days before the procedure without bridging, and resume after haemostasis is secured

Answer

Continue apixaban without interruption

Answer

Stop apixaban 5 days prior and bridge with therapeutic LMWH

Answer

Switch to warfarin for better control

Answer

Do not perform colonoscopy while on apixaban

Practice question