Table 2.
Periprocedural Anticoagulation Management
| Management Strategy* | Studies, n (%) | |
|---|---|---|
| Periprocedural Bridging | Pre- and postprocedural | 22 (79) |
| Only preprocedural | 2 (7) | |
| Only postprocedural | 4 (14) | |
| Not specified | 4 (14) | |
| Type of bridging anticoagulant | LMWH | 28 (100) |
| Unfractionated heparin | 6 (21) | |
| Dosing of bridging anticoagulant | Therapeutic | 18 (64) |
| Sub-therapeutic | 9 (32) | |
| Prophylactic | 16 (57) | |
| Not reported | 1 (4) | |
| Preprocedural Management | ||
| VKA interruption, days | ≥6 | 7 (25) |
| 5 | 19 (68) | |
| ≤4 | 9 (32) | |
| not reported | 3 (11) | |
| Last dose of LMWH, hours | < 12 | 1 (4) |
| 12–23 | 13 (46) | |
| ≥24 | 7 (25) | |
| NA (only postop bridging) | 2 (7) | |
| Not reported | 6 (21) | |
| Postprocedural Management | ||
| Restart of LMWH, hours | 0–23 | 16 (57) |
| ≥24 | 7 (25) | |
| Not specifically reported | 7 (25) | |
| Restart of VKA, hours | Evening of procedure | 10 (36) |
| Day after procedure | 18 (64) | |
| 2 or more days after procedure | 4 (14) | |
| Not reported | 6 (21) | |
| Initial dosing of VKA | Maintenance dose | 9 (32) |
| Loading dose | 3 (11) | |
| Not reported | 16 (57) | |
| Duration of bridging | Prespecified no. of days | 2 (7) |
| Until INR therapeutic | 12 (43) | |
| Until INR therapeutic on 2 consecutive days | 5 (18) | |
| Not reported | 9 (32) | |
Abbreviations: INR, international normalized ratio; LMWH, low molecular weight heparin; VKA, vitamin K antagonist.
*
Some studies implemented multiple strategies