• Hematol. Oncol. Clin. North Am. · Oct 2016

    Review

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

    • Benjamin R Bell, Alex C Spyropoulos, and James D Douketis.
    • University of Toronto, Toronto, Ontario, Canada. Electronic address: ben.bell@nygh.on.ca.
    • Hematol. Oncol. Clin. North Am. 2016 Oct 1; 30 (5): 1073-84.

    AbstractThe 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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