A 68-year-old on apixaban 5 mg twice daily for AF is scheduled for an elective total hip arthroplasty (high bleeding risk). eGFR is 80 mL/min/1.73 m²....

Question

A 68-year-old on apixaban 5 mg twice daily for AF is scheduled for an elective total hip arthroplasty (high bleeding risk). eGFR is 80 mL/min/1.73 m². What is the optimal perioperative anticoagulant plan?

Accepted Answer

Hold apixaban for 48-72 hours pre‑op without bridging and resume post‑op when hemostasis secured

Answer

Bridge with therapeutic LMWH after stopping apixaban 24 hours before surgery

Answer

Continue apixaban through surgery

Answer

Hold apixaban only morning of surgery; resume evening of surgery regardless of hemostasis

Answer

Switch to warfarin 1 week prior with heparin bridge

perioperative anticoagulation MCQ (SBA): High bleeding risk arthroplasty

A 68-year-old on apixaban 5 mg twice daily for AF is scheduled for an elective total hip arthroplasty (high bleeding risk). eGFR is 80 mL/min/1.73 m². What is the optimal perioperative anticoagulant plan?