Due to the unique characteristics of warfarin and the new oral anticoagulants, preparation for medical procedures and surgery requires a thoughtful and deliberate approach to care. A sound knowledge of the characteristics, half-life and side effects of the medications as well as the requirements for the desired procedure/surgery must be considered. Appropriate adjustments to medical therapies, close monitoring of patient status (pre- and post-operatively) and a coordinated plan for comprehensive anticoagulation management are essential to optimum patient outcomes.
What is the urgency of the procedure/surgery?
How can any bleeding risk be effectively managed while minimizing the stroke risk during this period?
What are the essential information elements that need to be considered when bridging a patient on anticoagulation therapy for a procedure/surgery?