For a patient with PE undergoing procedures like port placement in the first month, how do you manage anticoagulation?
What is your preferred agent (DOAC, warfarin, enoxaparin), and is periprocedural bridging necessary?
Answer from: Medical Oncologist at Community Practice
Due to their convenience, efficacy, and safety, I think direct oral anticoagulants (DOC) are the agents of choice for most cases of PE, DVT, or chronic prophylaxis. As per the package insert for Apixaban, for moderate or high risk invasive procedures, stop 48 hrs in advance, and for low risk, stop 2...
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Answer from: at Academic Institution
This is a very broad question and it is going to be hard to be very specific since the approach will vary depending on the clinical circumstances such as extent of PE, type, the urgency of the procedure, etc. The general principle is to wait at least 3 months before interruption of anticoagulation. ...
Answer from: at Academic Institution
Stop current anticoagulation when safe according to the anticoagulation used. Start low dose heparin and then in 6 hours, restart primary RX.
If on Coumadin, wait until INR less than 1.5 then restart to get to the desired INR.