UNASSIGNED: An increasing number of individuals are on novel oral anticoagulants (NOAC) for anticoagulation instead of @entity2067 antagonists (VKA) and roughly 10% of these individuals will require interruption of these agents for procedures annually. Recent evidence surrounding bridging as well as the FDA approval of a new NOAC call for a comprehensive review and update regarding periprocedural NOAC management. The periprocedural management of NOACs involves striking a balance between the risks of @entity548 and @entity1031 associated with interruption, bridging, and reinitiation of anticoagulation. NOACs have a distinct pharmacokinetic advantage in this setting with their quick onset and elimination from the body. Procedures at low risk for @entity548 do not require interruption and can be scheduled at the start of the next dosing interval. Procedures at moderate-high risk of @entity548 require interruption of NOAC for 5 half lives prior to the procedure to allow for adequate elimination of the drug. In light of new evidence highlighting the risks of @entity548 , and given shorter "unprotected" times with NOAC interruption versus VKA, @entity1 at low-moderate risk for @entity1031 should not be bridged when "unprotected" time is less than 96h. For @entity1 at high risk for @entity1031 , individual @entity1 and surgical factors need to be considered before the decision to bridge is made. The benefit of bridging these @entity1 who have a considerable risk of @entity548 may not outweigh the benefits. Focused randomized studies on periprocedural management of NOACs are urgently needed.

Periprocedural management of anticoagulation in XXXX taking novel oral anticoagulants: Review of the literature and recommendations for specific populations and procedures.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolism'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K']
@entity1 :: (9606,Species) :: ['patients']
