Question

A 60-year-old man with non-valvular atrial fibrillation on Apixaban requires an elective colonoscopy with anticipated polypectomy. His creatinine clearance is normal and CHA2DS2-VA score is 3. According to peri-procedural anticoagulation principles, what is the most appropriate management of his Apixaban?

Accepted Answer

Stop Apixaban 2-3 days before the procedure and restart within 24 hours post-procedure once haemostasis is secured

Answer

Continue Apixaban without interruption

Answer

Stop Apixaban 1 day before the procedure and restart the evening after

Answer

Switch to therapeutic low molecular weight heparin bridge

Answer

Stop Apixaban 7 days prior and do not restart for 2 weeks

Practice question