Surgical and Procedural Bleed Risk Stratification in Anticoagulated Patients: ISTH Guidance in Practice

Send us Fan MailPerioperative anticoagulation management is a common and complex clinical challenge. In this episode of CLOT Conversations, Drs. James Douketis and Joseph Shaw discuss new ISTH guidance on surgical and procedural bleed risk stratification in anticoagulated patients.The discussion explores why updated guidance was needed, addressing inconsistencies in prior schemas, and introduces a more detailed, procedure-specific framework. The authors outline a three-tier classification—minimal, low/moderate, and high bleed risk—and its implications for anticoagulation management.The episode focuses on real-world application, including patient-specific factors, procedural variability, and interdisciplinary communication. It also highlights evidence gaps and ongoing research such as PAUSE2 and ACE-HIGH.https://www.jthjournal.org/article/S1538-7836(26)00055-3/abstract [Subscription required for full paper]Support the showhttps://thrombosiscanada.caRegister today for our upcoming conference on November 7, 2026 in Montreal at https://thrombosiscanada.ca/2026ConferenceTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada