How to manage anticoagulation/antithrombotic medications peri-procedurally can be a bit of a nuanced topic. More than one guideline exists for radiology procedures, practice guidelines are periodically updated based upon new data, and ultimately preferences on how to mange these medications will be decided by whoever is performing the procedure (which at times can lead to variable practice).
This page is designed to try and organize some of the information about this topic into a format that is easier to reference. Keep in mind that anticoagulation/antithrombotic medications are one component of evaluating a patient’s bleeding risk prior to a procedure, another component are key laboratory values that are explained more on a separate page here.
WHAT CLASSES OF MEDICATIONS SHOUDL BE CONSIDERED?
When thinking about pharmacological anticoagulation there are a few key medications/medication categories that should be considered. These categorizations make it easier to follow the guidelines (which typically have recommendations organized by the same category/drug classes listed below):
- Vitamin K antagonists: classically Warfarin/Coumadin falls in this category.
- Heparins: there are a few types of heparins:
- Low molecular weight: Enoxaparin, Dalteparin
- Unfractionated: often just called unfractionated heparin
- Direct thrombin inhibitors: Argatroban, Bivalirudin, Dabigatran
- Factor Xa Inhibitors: Apixaban, Betrixaban, Edoxaban, Fondaparinux, Rivaroxaban
- NSAIDs: Aspirin, Ibuprofen, Indomethacin, Ketorolac, etc.
- Thienopyridines: Clopidogrel, Cangrelor, Prasugrel etc.
- Glycoprotein IIb/IIIa inhibitors: Abciximab, Eptifibatide, Tirofiban
- Phosphodiesterase inhibitors: Cilostazol, Dipyridamole
Page Updated: 04.14.19