[Anticoagulation and platelet aggregation inhibition in urology : Update on peri-interventional management]

Perioperative management of antithrombotic therapy is challenging in the daily clinical practice and requires an individualized balancing between bleeding and thromboembolic risks. The structured risk stratification is based on patient medical history and validated scores. In cases of low bleeding risk, anticoagulation can often be continued; however, in urology an elevated bleeding risk is frequently present due to the high vascularity of the organs involved. Direct oral anticoagulants (DOAC) are typically only temporarily interrupted and bridging therapy is generally not indicated. The timing of discontinuation is determined by renal function and bleeding risk. Only patients at high thromboembolic risk should receive bridging therapy at full therapeutic dosage. The discontinuation of antiplatelet agents within the first month following stent implantation is associated with a high risk of stent thrombosis.