3 responses to “PAUSE Trial & Thrombosis Canada Guidelines: Practice Tip”

  1. Does the no bridging apply to high risk AFIB patients. The average CHADS2 score in the Pause trial is 2.1

  2. Hi Riley Hicks,
    You are correct! You do not need to bridge patients on DOACs, even if their CHADS2 score is high, due to their predictable pharmacokinetics. Post-operatively, if patients are at a higher risk of thromboembolism, you may want to consider giving prophylactic doses of LMWH or a reduced dose of DOAC as early as POD1, as long as the surgical team feels that hemostasis is adequate.

  3. I’m not sure I agree with putting colonoscopy under “Low bleeding risk”. A polypectomy is usually considered a high bleeding risk procedure because they bleed a lot.
    If it is a colonoscopy withOUT polypectomy then yes, it would be low risk. However, there is no way to know ahead of time whether a polyp will be encountered or not. I suppose it’s possible to schedule a second colonoscopy with interruption of the DOAC, but that isn’t a very practical approach.

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