Periprocedural Anticoagulation and Antiplatelet Medications Management for Interventional Radiology Procedures

Purpose of Review A large subset of patients undergoing Interventional Radiology procedures are on anticoagulation and/or antiplatelet therapy. Therefore, careful assessment of the coagulation status should be part of every patient's preprocedural evaluation to minimize the risk of bleeding. Every Interventional radiologist should be aware of the different medications that can affect coagulation parameters and how to properly manage them. Recent Findings After a thorough literature search, the most recent and relevant articles on periprocedural management of anticoagulation and antiplatelet medications for patients undergoing percutaneous and endovascular image-guided procedures were reviewed. Consensus guidelines from the Society of Interventional Radiology and other society guidelines showed few differences; however, there is no strong evidence on the definite timing to stop and resume those medications safely in the periprocedural period. Summary Currently used anticoagulation and antiplatelet medications are discussed in this review, with regards to their mechanism of action, pharmacokinetics, indications, and periprocedural management according to recent studies and different societal guidelines. The recommendations are presented in a clear and easy to follow diagram and table, along with recommendations regarding drug reversal. In addition, a brief review of the basic principles, physiology, and pharmacology of hemostasis is discussed.