A 60-year-old with AF on apixaban needs urgent laparoscopic cholecystectomy for acute cholecystitis. Last apixaban dose was 8 hours ago; eGFR 80. High...

Question

A 60-year-old with AF on apixaban needs urgent laparoscopic cholecystectomy for acute cholecystitis. Last apixaban dose was 8 hours ago; eGFR 80. High bleeding risk procedure and cannot wait. What reversal approach is reasonable?

Accepted Answer

Four-factor prothrombin complex concentrate (4F‑PCC)

Answer

No reversal; proceed

Answer

Vitamin K 10 mg IV

Answer

Fresh frozen plasma

Answer

Dabigatran‑specific antidote

us-abim MCQ (SBA): Urgent Surgery-DOAC Reversal

A 60-year-old with AF on apixaban needs urgent laparoscopic cholecystectomy for acute cholecystitis. Last apixaban dose was 8 hours ago; eGFR 80. High bleeding risk procedure and cannot wait. What reversal approach is reasonable?