. Author manuscript; available in PMC: 2019 Apr 1.

Published in final edited form as: Surg Clin North Am. 2018 Feb 3;98(2):219–238. doi: 10.1016/j.suc.2017.11.003

Table 6.

New trends in anticoagulation.

	Current (or Historical) Standard of Care	New Trend
Anticoagulant choice	LMWH/VKA 1^st line	DOACs 1^st line SAMeT2R2 to identify patients at high risk of VKA failure.
Extended duration therapy for unprovoked VTE	Prolonged anticoagulation with no testing, or d dimer or duplex to determine length of anticoagulation.	HERDOO score to identify low risk women who can avoid long term anticoagulation.
Extended duration therapy for unprovoked VTE	Long term full dose anticoagulation with VKAs	Long term prophylactic dosing with rivaroxaban or apixaban or ASA.
Extended thromboprophylaxis	Extended duration prophylaxis for open abdominal/pelvic cancer operations only.	Include laparoscopic cancer resection. Betrixaban for extended thromboprophylaxis in the medically ill.
Bridging	Routine bridging for atrial fibrillation and prosthetic valves.	No bridging for CHADS2 ≤ 2; selective bridging for prosthetic valves.
	Always hold anticoagulation for invasive procedures.	Select procedures safer to continue anticoagulation.
	Hold DOACs 2–4 days	Hold DOACs 1–2 days