Anaes Cases · Anaesthesia for the co-morbid & elderly
The anticoagulated elderly patient for the non-cardiac surgery
The short case — the DOAC (the apixaban, often no bridging) and the dual antiplatelet (the recent stent, the cardiology coordination, the aspirin continued) management. The balance of the thrombosis (the stroke, the stent thrombosis) against the bleeding.
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Prompt
A 76-year-old man with the atrial fibrillation on the apixaban and the recent coronary stent on the aspirin and the clopidogrel, for the urgent cholecystectomy. Discuss the perioperative anticoagulation and the antiplatelet management.
Presentation
A 76-year-old man with atrial fibrillation on apixaban and a drug-eluting coronary stent placed 4 months ago (on aspirin and clopidogrel), presents with acute cholecystitis needing urgent laparoscopic cholecystectomy. Discuss the perioperative anticoagulation and antiplatelet management.
References1ShowHide
- [5]Budiarto RM, et al. Contemporary approaches to perioperative anticoagulant management in surgical patients: a literature review. Curr Med Res Opin, 2026.PMID 41763902