Table 13 Simple guidelines for managing anticoagulation during procedures/surgeries.

Adapted from Kearon C, Hirsh J. Management of Anticoagulation Before and After Elective Surgery. NEJM 1997; 336: 1506-1511.

CONDITIONS	PRE PROCEDURE	POST PROCEDURE
Acute VTE	.	.
-- Month 1	*              Heparin (2)	**              Heparin (2)
-- Month 2-3	*	**              Heparin (2)
Recurrent VTE	*.	**            SC heparin (3)
Acute arterial embolism	.	.
-- Month 1	*               Heparin (2)	**              Heparin (2)
Mechanical heart valve	*.	**            SC heparin (3)
NVAF	*.	**            SC heparin (3)

• * = Hold Warfarin at apppropriate time (See "Detail of protocols for managing anticoagulation during procedures/surgeries, Table 10, 11, 12) or continue Warfarin if risk of bleeding is low. .
• ** = Start Warfarin at appropriate time if Warfarin is withheld. (See "Detail of protocols for managing anticoagulation during procedures/surgeries, Table 10, 11, 12)
• No detail in managing patients with different operative bleeding risk, or patients with different thromboembolic risk.
• VTE = Venous thromboembolism.NVAF = Non valvular atrial fibrillation.
• (2) = Unfractionated (UFH) or low molecular weight heparin (LMWH).
• (3) = For prevention of venous thromboembolism only.