Related Experiment Video
Updated: Jun 21, 2026

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
Published on: July 31, 2016
Perioperative anticoagulant management
Paul J Grant1, Daniel J Brotman, Amir K Jaffer
1Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, 3119 Taubman Center, Ann Arbor, MI 48109-5376, USA.
Abstract:
The oral anticoagulant warfarin is a common medication that requires special consideration in the perioperative period. Although some procedures do not require warfarin interruption, the majority will necessitate its temporary cessation due to the risk of bleeding. Determining whether patients will benefit from the temporary use of a heparin product while warfarin is discontinued perioperatively (so-called "bridging" therapy) needs to take into consideration the risk of bleeding balanced with the risk of thromboembolism. Perioperative care also requires minimizing the risk of venous thromboembolism (VTE). Understanding the patient-specific and procedure-specific risks for VTE is paramount to employ optimal risk reduction strategies. This article uses a case-based approach to present the topics of perioperative warfarin management and postoperative VTE prevention.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Aneurysm IV: Nursing Management
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Peripheral Artery Disease V: Postoperative Nursing Management
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...