Perioperative Elective Management in Patients Treated with Direct Oral Anticoagulants – Practical Guide

Introduction: Despite clear, relatively easy to use guidance, many clinicians find the perioperative management of direct oral anticoagulants (DOACs) challenging. Inappropriate antithrombotic management can delay procedures and lead to bleeding or thromboembolic complications. Materials and methods: We aimed to describe perioperative management practices related to planned procedures regarding DOACs in accordance with the applicable guidelines of cardiological and surgical societies. Results: Management of a patient treated with DOACs before surgery may be as follows: performing the procedure without discontinuing DOACs, discontinuing DOACs before surgery and, in rare cases, discontinuing DOACs with heparin bridging therapyConclusions: In everyday clinical practice, doctors of many specialties determine the perioperative management in patients treated with anticoagulants.