A 74-year-old with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin (INR 2.6). He is scheduled for elective colonoscopy with possible p...

Question

A 74-year-old with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin (INR 2.6). He is scheduled for elective colonoscopy with possible polypectomy. What is the best periprocedural anticoagulation plan?

Accepted Answer

Hold warfarin pre-procedure without heparin bridging; resume post-procedure once hemostasis is secure.

Answer

Continue warfarin through the procedure.

Answer

Bridge with full-dose low-molecular-weight heparin when INR falls below 2.0.

Answer

Switch to a DOAC 48 hours before the procedure.

Answer

Stop warfarin and start IV unfractionated heparin until the procedure.

us-abim MCQ (SBA): Periprocedural Anticoagulation

A 74-year-old with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin (INR 2.6). He is scheduled for elective colonoscopy with possible polypectomy. What is the best periprocedural anticoagulation plan?