TAKE-HOME MESSAGE
This review presented a standardized approach based on procedure-related bleeding risk to guide the perioperative management of patients taking direct oral anticoagulants (DOACs) and undergoing elective procedures. Minimal-risk procedures may not require DOAC interruption, low- to moderate-risk procedures typically involve stopping DOACs 1 day before and restarting 1 day after the procedure, and high-risk procedures require a 2-day interruption. This strategy was associated with low rates of thromboembolism (0.2–0.4%) and major bleeding (1.0–2.0%).
For patients taking DOACs in emergent or urgent surgical situations, clinicians should consider preoperative DOAC level testing to guide the use of reversal agents (prothrombin complex concentrates, idarucizumab, and andexanet alfa). Adopting standardized protocols for elective procedures, along with tailored approaches for emergent or urgent cases, can help optimize outcomes and minimize complications in this patient popu
for more details visit the below link :
https://www.practiceupdate.com/content/perioperative-management-of-patients-receiving-doacs/169182
