[Periprocedural management of oral anticoagulation - Limit the bleeding risk in elective procedures]

The decision to continue or to stop oral anticoagulant therapy in the peri-interventional period is based on the evaluation of bleeding risk associated with the invasive procedure or with the anaesthetic technique, especially when a deep nerve block or a neuraxial block is planned, and on the evaluation of patient-associated risk factors. Anticoagulant bridging during the preoperative period as well as an early resumption of anticoagulation in the postoperative period are associated with increased bleeding rates without reduction of thromboembolic events, thus limiting the indications of bridging to patients with chronic vitamin K agonist therapy and a high thrombotic risk.