Question

A 73-year-old on apixaban 5 mg BID for AF will undergo elective high-bleeding-risk cancer surgery; CrCl 70 mL/min. How should anticoagulation be managed perioperatively?

Accepted Answer

Hold apixaban 2 days before surgery; no heparin bridging

Answer

Continue apixaban through surgery

Answer

Hold apixaban 1 day prior only

Answer

Bridge with therapeutic LMWH after holding 2 days

Answer

Check anti-Xa level and individualize only

Practice question

A 73-year-old on apixaban 5 mg BID for AF will undergo elective high-bleeding-risk cancer surgery; CrCl 70 mL/min. How should anticoagulation be managed perioperatively?