A 67-year-old man with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin for stroke prevention. He is scheduled for elective colonoscopy...

Question

A 67-year-old man with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin for stroke prevention. He is scheduled for elective colonoscopy with planned polypectomy. What is the recommended perioperative anticoagulation strategy?

Accepted Answer

Hold warfarin 5 days prior without heparin bridging and resume postprocedure when hemostasis is secure

Answer

Continue warfarin through the procedure

Answer

Stop warfarin 5 days prior and bridge with therapeutic LMWH

Answer

Stop warfarin 2 days prior without bridging

Answer

Switch to a DOAC for 1 week before the procedure

us-usmle-step-2 MCQ (SBA): Perioperative Anticoagulation

A 67-year-old man with nonvalvular atrial fibrillation (CHA2DS2-VASc 3) takes warfarin for stroke prevention. He is scheduled for elective colonoscopy with planned polypectomy. What is the recommended perioperative anticoagulation strategy?