Xarelto and Surgery

Managing anticoagulation drugs in patients undergoing surgeries is challenging. Any interruption of the anticoagulation medication can increase the risk of thromboembolism. On the other hand, any surgery or invasive procedure that have associated bleeding risks are increased by the anticoagulants that are taken to prevent thromboembolism. If bleeding is present after a surgical procedure, then the anticoagulants may need to be discontinued for a longer period which will increase the risk of thromboembolism. A balance between the two risks has to be reached for each patient.
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ESTIMATING THROMBOEMBOLIC RISK — The major factors that increase thromboembolic risk are atrial fibrillation, prosthetic heart valves, and recent venous or arterial thromboembolism (eg, within the preceding three months).

Atrial fibrillation — Atrial fibrillation accounts for the highest percentage of patients for whom perioperative anticoagulation questions arise. Importantly, patients with atrial fibrillation are a heterogeneous group; risk can be further classified according to clinical variables such as age, hypertension, congestive heart failure, diabetes, prior stroke, and other vascular disease (table 1) [2,7]. The CHA2DS2-VASc score (table 4) (calculator 1), which incorporates these variables, is discussed in detail separately; of note, use of risk scores has not been prospectively validated in the perioperative setting. (See "Atrial fibrillation: Risk of embolization".)   Source: UpToDate.com

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Please follow your physician's advice when considering Xarelto and surgery.