Management of Perioperative Anticoagulation


To decide the duration and end of a temporary interruption of anticoagulation, management of perioperative anticoagulant therapy necessitates an inter professional approach. In specific situations, parenteral anticoagulation during a temporary interruption may be necessary based on the unique risks and advantages of the patient and the procedure. The guidelines for postoperative anticoagulation treatment for individuals with non-valvular atrial fibrillation having non-cardiac surgery are explained in this activity. Medical professionals have everyday challenges in managing patients who are on anticoagulation and anti-aggregation treatment. Surgery-related and postoperative thrombotic events are more likely when medication is interrupted. But if these medications aren't stopped, it can lead to a series of unfavourable effects, from small to uncontrollable bleeding, and increase the chance of bleeding during surgery. Thus, balancing the risks of bleeding and thromboembolism allows for the best therapy of these individuals. The choice of whether or not to stop anticoagulation or anti-aggregation therapy before to surgery depends on a number of case-based factors. These include assessing a person's inherent risk of bleeding, the risk of complications caused by the surgical treatment, the timing of stopping and starting anticoagulant medicine, and whether to employ bridging therapy.

The most frequent indications for anticoagulation medication are deep vein thrombosis, pulmonary embolism, atrial fibrillation, and following the implantation of artificial heart valves. Patients who have had percutaneous coronary interventions are frequently given dual antithrombotic therapy, and patients with a history of stroke, coronary artery by-pass grafting, or essential thrombocytosis may also need antithrombotic therapy. Numerous factors, including hereditary conditions, cancer, sepsis, surgery, and anti-aggregation and anticoagulant medications, might affect the physiologic haemostasis process.

The strategy advocated by various well-known guidelines is founded on four factors that are meant to direct the doctor in circumstances involving elective surgery. Establish the patient's thromboembolic risk, atrial fibrillation, artificial heart valves, and recent thromboembolism are the three main factors associated with an increased risk of thromboembolic events. Patients with prosthetic valves will be categorised according to their risk factors based on their location, kind of valve, number of prosthetic valves, and related cardiac risk factors. The best strategy for making this choice is to weigh the advantages and disadvantages of stopping anticoagulation. It is essential to use clinical judgement because there is no simple score or calculator to determine the patient's classification.  Anticoagulation interruption will generally be advantageous for patients who have a high risk of bleeding. However, bridging therapy and the smallest amount of anticoagulant removal time may be beneficial for patients with high thromboembolic risk. This situation is shown by the patient receiving surgical treatment cancer surgery. In other circumstances, delaying the elective surgical operation after weighing the risks and advantages is an appropriate choice.

Poor perioperative anticoagulation treatment can lead to two significant problems. The first is haemorrhage, which happens if the healthcare professional delays stopping anticoagulant treatment as needed. However, because surgical operations themselves result in a hypercoagulable condition, individuals who have their anticoagulation terminated too early in the perioperative are at a significant risk of thromboembolic events. Therefore, the proper discontinuation of anticoagulation during the perioperative phase requires the managing provider to pay close attention and strike a precise balance between the potentially serious problems of thrombosis and bleeding.

Clinical Pathology & Laboratory Medicine Peer- reviewed which will be dedicated to advancing diagnosis of diseases based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of biochemistry, microbiology, haematology and molecular pathology.

Authors can submit their manuscripts as an email attachment to

Best Wishes,
Journal Co-ordinator
Clinical Pathology & Laboratory Medicine