Table 1. Surgery/procedure classification based on bleed risk.
High bleed risk | Low bleed risk |
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Any surgery requiring neuraxial anesthesia • Neuraxial anesthesia/injection—epidural anesthesia/injection. |
Gastrointestinal procedures • Colonoscopy, gastroscopy, sigmoidoscopy—endoscopic retrograde pancreaticocholangiography—capsule endoscopy—push enteroscopy—Barrett's esophagus ablation. |
Major intracranial or neuraxial surgery • Brain cancer resection—laminectomy or neuraxial tumor resection—intracranial (subdural, epidural) bleed evacuation. |
Cardiac procedures: • Permanent pacemaker implantation or battery change. • Internal cardiac defibrillator implantation or battery change—artrioventricular node ablation—coronary artery angiography (radial approach). |
Major thoracic surgery • Lobectomy, pneumonectomy, esophagectomy. |
Dental procedures • Tooth extraction (up to two extractions) —endodontic (root canal) procedure. |
Major cardiac surgery • Coronary artery bypass—valve replacement or repair. |
Skin procedures and skin biopsy |
Major vascular surgery • Aortic aneurysm repair—aorto-bifemoral bypass, popliteal bypass—carotid endarterectomy. |
Eye procedures and phacoemulsification (cataract) |
Major abdominopelvic surgery • Hepatobiliary cancer resection—pancreatic cancer or pseudocyst resection—colorectal and gastric cancer resection—diverticular disease resection. • Inflammatory bowel disease resection—renal cancer resection—bladder cancer resection—endometrial cancer resection—ovarian cancer resection—radical prostatectomy. |
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Major orthopaedic surgery • Hip arthroplasty or hip fracture repair—knee arthroplasty or tibial osteotomy—shoulder arthroplasty—metatarsal osteotomy. |
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Other major cancer or reconstructive surgery • Head and neck cancer surgery—reconstructive facial, abdominal, limb surgery. |