A 71-year-old with AF on apixaban 5 mg BID is scheduled for elective laparoscopic colectomy (high bleeding risk). eGFR 70 mL/min. According to CHEST g...

Question

A 71-year-old with AF on apixaban 5 mg BID is scheduled for elective laparoscopic colectomy (high bleeding risk). eGFR 70 mL/min. According to CHEST guidance, how should apixaban be managed perioperatively (no neuraxial anesthesia)?

Accepted Answer

Hold apixaban 2 days before and resume 48-72 hours post-op if hemostasis secure

Answer

Continue apixaban through surgery

Answer

Hold apixaban 1 day before and resume morning after

Answer

Bridge with therapeutic LMWH after stopping apixaban

Answer

Switch to warfarin 1 week pre-op

us-abim MCQ (SBA): Perioperative DOAC Management

A 71-year-old with AF on apixaban 5 mg BID is scheduled for elective laparoscopic colectomy (high bleeding risk). eGFR 70 mL/min. According to CHEST guidance, how should apixaban be managed perioperatively (no neuraxial anesthesia)?