Contents
Managing Anticoagulation During Surgery: What You Need to Know
Published: Oct 29, 2023
Balancing anticoagulation during surgery is tricky. It's about preventing clots without causing too much bleeding.
Understanding Thromboembolism and Bleeding Risks
When anticoagulation is stopped for surgery, the risk of clots increases, but continuing it might mean more bleeding. Doctors need to weigh these risks carefully to avoid serious complications. The decision often depends on the type of surgery and the patient's health history, such as heart conditions or recent clotting events.
What Are Thromboembolic Risks?
Thromboembolic risk is how likely you are to develop blood clots. Factors like atrial fibrillation, recent strokes, or heart valve issues increase this risk. For example, atrial fibrillation can lead to strokes if not managed properly, so careful planning is needed when surgery is involved.
Bleeding Risks Explained
Bleeding risk varies with the surgery type and patient health. High-risk procedures like heart surgery require stopping anticoagulants, while low-risk ones like dental work might not. Other factors, such as age and kidney function, also play a role in deciding whether to interrupt anticoagulation.
Deciding on Anticoagulation Interruption
Interrupting anticoagulation depends on balancing thromboembolic and bleeding risks. High bleeding risk generally means stopping anticoagulants, while low-risk procedures might allow continuation. The decision requires careful clinical judgment and consideration of individual patient factors.
Frequently Asked Questions
It's a condition where blood clots form and travel through blood vessels.
Stopping them reduces bleeding risk during surgery.
Yes, for low-risk procedures, they might not need to be stopped.
Surgery type, age, and kidney function can increase risk.
It's assessed based on conditions like atrial fibrillation and recent strokes.
Key Takeaways
Balancing anticoagulation during surgery requires careful evaluation of both thromboembolic and bleeding risks.
References
- Douketis JD, Spyropoulos AC, Murad MH, et al. Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline. Chest 2022; 162:e207.
- Healey JS, Eikelboom J, Douketis J, et al. Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin: results from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) randomized trial. Circulation 2012; 126:343.
- Sherwood MW, Douketis JD, Patel MR, et al. Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation 2014; 129:1850.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
AI Doctor Visit Required
Appointments available 24/7
Top licensed doctors
Available in all 50 states
Full service care
Prescriptions, referrals & treatment
No insurance needed
All notes available in Doctronic
15-min consultation. No hidden costs.
AI Doctor Visit Required
Please Chat With Our AI Doctor First
Our AI doctor assessment helps our human doctors prepare for your video visit and provide better care
For safety reasons we have been forced to end this consultation.
If you believe this is a medical emergency please call 911 or your local emergency services immediately.
If you are experiencing emotional distress, please call the the Suicide & Crisis Lifeline at 988 or your local crisis services immediately.
Contact us
You can also email us at help@doctronic.ai
We aim to reply within 5-7 days
How likely are you to recommend Doctronic to friends or family?