Perioperative Management of Oral Anticoagulation in Patients with Venous Thromboembolism

Authors

John R. Sherwood, Henry Ford HealthFollow
Austin Parsons, Henry Ford HealthFollow
Hiba A. Al Jammala, Henry Ford HealthFollow
Scott Kaatz, Henry Ford HealthFollow

Recommended Citation

Sherwood JR, Parsons A, Al Jammala H, and Kaatz S. Perioperative Management of Oral Anticoagulation in Patients with Venous Thromboembolism. Med Clin North Am 2025;109(4):943-956.

Document Type

Article

Publication Date

7-1-2025

Publication Title

The Medical clinics of North America

Abstract

Perioperative management of anticoagulation for patients with history of venous thromboembolism (VTE) is based on the patient's individual recurrent VTE risk and procedural bleeding risk. The American College of Chest Physicians (ACCP) guidelines can help in estimating VTE recurrence risk. For warfarin, holding 5 days prior to a procedure, and restarting the night of or morning after is suggested. For direct oral anticoagulants, holding for 1 calendar day (as opposed to 24 hours) in low-to-moderate bleeding risk procedures, and 2 days for high bleeding risk procedures has been shown to be safe and is supported by the ACCP guidelines.

Medical Subject Headings

Humans; Venous Thromboembolism; Anticoagulants; Perioperative Care; Administration, Oral; Warfarin; Practice Guidelines as Topic; Hemorrhage; Recurrence

PubMed ID

40500091

Volume

109

Issue

4

First Page

943

Last Page

956