ACCP-Management of Oral Anticoagulation During Invasive Procedures
High Risk Patients (Grade 2C)
(recent VTE, mitral valve replacement, ball/cage valve)
- Hold warfarin ~4d prior to procedure
- Allow INR to return to normal
- Begin full dose IV UFH or full dose LMWH as INR falls (~2d prior to procedure)
- Stop IV UFH 5h prior to procedure or LMWH 12-24 hours prior to procedure
Ansell J, et al. Chest 2001; 119: 22S-38S