American Society of Hirudotherapy

Update on perioperative bridging in patients on chronic oral anticoagulation

Narrative review published in Expert review of cardiovascular therapy (2009)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical LiteratureFaltas et al. · Expert review of cardiovascular therapy, 2009

Abstract

Oral anticoagulation (OAC) with vitamin K antagonists is commonly used for long-term prevention or treatment of arterial or venous thromboembolism. In the USA alone, approximately 250,000 patients will require temporary interruption of OAC annually. Managing anticoagulation in those patients on chronic OAC who require invasive procedures continues to be a major clinical dilemma. This article summarizes the existing evidence in light of the recommendations of the American College of Chest Physicians. Management of anticoagulation in the perioperative period will continue to be an important clinical challenge and an evolving area of research. If new oral anticoagulants are successful in replacing warfarin, the entire perioperative anticoagulation scene will change.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAdministration, OralAnticoagulantsBlood Loss, SurgicalEvidence-Based MedicineHeparinHumansPerioperative CarePractice Guidelines as TopicRisk FactorsVenous ThromboembolismVitamin K

Summary

This review summarizes evidence and American College of Chest Physicians guidance on temporarily interrupting chronic oral anticoagulation with vitamin K antagonists for invasive procedures, affecting about 250,000 US patients annually, concluding perioperative anticoagulation management remains challenging as newer oral anticoagulants emerge.

Why This Matters for Hirudotherapy

This review summarizes the evidence and clinical guidelines for perioperative bridging anticoagulation in patients on chronic oral anticoagulants who require invasive procedures. It focuses entirely on the management of traditional vitamin K antagonists and does not discuss direct thrombin inhibitors, hirudotherapy, or leeches. Because the article lacks any mention of leech-derived proteins or related therapies, it has no direct or indirect relevance to the American Society of Hirudotherapy's domain.

Citation

Reference (Vancouver style)

Faltas B, Kouides PA. Update on perioperative bridging in patients on chronic oral anticoagulation. Expert Rev Cardiovasc Ther. 2009;7(12):1533-1539. doi:10.1586/erc.09.128. PMID: 19954315

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

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