Update on Edoxaban for the Prevention and Treatment of Thromboembolism: Clinical Applications Based on Current Evidence
Table 3
Interruption/holding of edoxaban for procedures [17, 30, 31].
Low risk or minor surgery (procedures with 2-day risk for major bleeding 0–2%)
Aiming for mild to moderate residual anticoagulant effect at surgery (12%–25%) or 2-3 half-lives
High risk or major surgery (procedures with 2-day risk for major bleeding 2%–4%)
Aiming for no or minimal residual anticoagulant effect (3%–6%) at surgery or 4-5 half-lives
Edoxaban
10–14 hr
24 hr
48–72 hr
Types of surgical procedures
(i) Cholecystectomy (ii) Abdominal hernia repair (iii) Abdominal hysterectomy (iv) Coronary angiography/percutaneous coronary intervention (v) Electrophysiologic testing (vi) Pacemaker/cardiac defibrillator insertion (vii) Gastrointestinal endoscopy ± biopsy, enteroscopy, biliary/pancreatic stent without sphincterotomy, and endosonography without aspiration (viii) Minor plastic surgery (carpal tunnel repair) (ix) Minor orthopedic surgery/arthroscopy (x) Minor gynecologic surgery (dilation and curettage) (xi) Minor dental procedures (extractions) (xii) Minor skin procedures (cancer excision) (xiii) Minor eye procedures (cataract)
(i) Major cardiac surgery (surgical heart valve replacement/coronary artery bypass grafting) (ii) Major neurosurgical procedures (iii) Major cancer surgery (head and neck/abdominal/thoracic) (iv) Major orthopedic surgery (joint replacement/laminectomy) (v) Major urologic surgery (prostate/bladder resection) (vi) Major vascular surgery (vii) Kidney biopsy (viii) Polypectomy, variceal treatment, biliary sphincterectomy, and pneumatic dilation (ix) Endoscopically guided fine-needle aspiration
