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Procedure Bleed risk INR target Platelets Anticoagulant hold

Warfarin

Hold 5 days for moderate / high-bleed-risk procedures. Bridge with LMWH for high thromboembolic risk patients (mechanical valve, recent VTE).

DOACs (apixaban, rivaroxaban, dabigatran)

Hold 24-48 h for moderate / high-risk procedures depending on renal function. Restart 24 h post-procedure if hemostasis adequate.

Antiplatelets

Aspirin generally continued. Hold clopidogrel/prasugrel/ticagrelor 5-7 days for moderate / high-risk procedures.

Patient-specific risk always wins. These thresholds are a starting point. Discuss with the proceduralist when there's competing thromboembolic risk (recent stent, mechanical valve, AF + prior CVA) — bridging strategy is highly individualized.