Question

A 73-year-old with nonvalvular AF on apixaban 5 mg BID is scheduled for elective colectomy (high bleeding risk). Renal function is normal. Perioperative plan?

Accepted Answer

Stop apixaban 24 h pre-op only

Answer

Continue apixaban through surgery

Answer

Bridge with therapeutic LMWH after stopping apixaban

Answer

Stop apixaban 48 h before surgery; no heparin bridging; resume post-op when hemostasis secure

Answer

Switch to warfarin 1 week before surgery

Practice question

A 73-year-old with nonvalvular AF on apixaban 5 mg BID is scheduled for elective colectomy (high bleeding risk). Renal function is normal. Perioperative plan?