Is the patient on concomitant antiplatelet therapy?
Is the patient taking concurrent medications that interact with OAC levels?
Does patient have nonvalvular AF?
Does > 1 of the following apply? • High risk features of the patient • Procedure done in a location associated with potentially catastrophic bleed
Did the patient have cardiac valve surgery?
Can patient tolerate oral medications?
What is the post-procedural bleed risk?
Is there a plan or indication to administer parenteral agent after procedure?
Does the patient fall into 1 of the following groups? • Nil Per Os (nothing by mouth) • Cancer-associated VTE • Pregnancy
What was the original anticoagulant?
Does patient have a CNS hemorrhage (e.g. ICH, spinal, ocular bleeding)?
Patients who are at high thrombotic risk will likely benefit from restarting anticoagulation, even if the risk of rebleeding is high. If there is an ongoing indication of OAC in an interrupted patient, clinicians must evaluate whether the risk of bleeding temporarily or permanently outweighs the benefit of treatment or thromboprophylaxis with OAC. The following questions help assess bleed characteristics that contribute to the risk of restarting, reversible factors that may have contributed to the bleed, indications against restarting, and indications for anticoagulation.