Perioperative Management of the Direct Oral Anticoagulants: A Case-Based Review

Benjamin R. Bell, Alex C. Spyropoulos, James D. Douketis

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach. A free online clinical guidance tool is available from Thrombosis Canada that includes the proposed management algorithm.

Original languageEnglish
Pages (from-to)1073-1084
Number of pages12
JournalHematology/Oncology Clinics of North America
Volume30
Issue number5
DOIs
StatePublished - 1 Oct 2016
Externally publishedYes

Keywords

  • Algorithm
  • Direct oral anticoagulants
  • Perioperative management
  • Thrombosis

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