Procedural

Question 1

What are category 1 (low risk bleeding procedures)?

Answer 1

• non-tunneled venous catheter
• dialysis access interventions
• central line removal
• IVC filter
• catheter exchange
• thoracentesis/paracentesis

Question 2

Med instructions for category 1

Answer 2

Plavix = hold for 5 days
Aspirin = continue
Warfarin = hold 3-5 days

Question 3

What are category 2 (moderate risk bleeding procedures)?

Answer 3

• angiography (art intervention up to 7F access)
• venous interventions
• chemo or radio-embolization
• UFE
• transjugular liver bx
• tunneled venous catheter
• abscess drainage
• bx (not superficial or renal)
• perc cholecystostomy

Question 4

Med instructions for category 2

Answer 4

Plavix = 5 days
Aspirin = continue 
Warfarin = 5 days

+ LMWH = stop 12 hours before
+ Dabigatran = 2-3 days (48 hours)

Question 5

What are category 3 (high risk bleeding procedures)?

Answer 5

TIPS
Renal bx, RFA, Nephrostomy tube placement
Biliary interventions (new tract)

Question 6

Med instructions for category 3

Answer 6

NEED TO HOLD ASPIRIN FOR 5 DAYS IN THESE CASES!
(warfarin and Plavix are the same as other categories – 5 days)

+ LMWH = 2 doses (instead of 1)
+ Dabigatran = 2-3 days (48 hours)
+ Ibuprofen = 24 hours