For surgeries with a low bleeding risk, when should NOACs be recommenced after the procedure?

For surgeries characterized by a low bleeding risk, the appropriate timing for resuming non-vitamin K oral anticoagulants (NOACs) is typically 1 day after the procedure. This recommendation is based on the understanding that NOACs have a relatively rapid onset of action and a short half-life, which means that the anticoagulant effect diminishes quickly.

After low-risk surgeries, the patient's bleeding risk is generally minimal, allowing for a swift resumption of anticoagulation therapy. Starting NOACs again on the first day post-operation helps in minimizing the risk of thromboembolic events in patients who are at risk, while still ensuring the surgical site has sufficiently healed to mitigate the risk of significant postoperative bleeding.

In contrast, longer intervals such as 2, 3, or 5 days may be unnecessarily cautious in cases where bleeding risk is low, potentially placing patients at greater risk for thromboembolic complications due to the delay in resuming their anticoagulant therapy. Understanding the specific risks associated with individual surgeries, along with the pharmacokinetics of NOACs, helps in making this decision.