For most procedures, perioperative management will be driven by thromboembolic risk.
Anticoagulants should not be discontinued without consultation with the provider who is managing the anticoagulants to avoid significant issues.
Bruising and hematoma formation is possible.
General Recommendations for Pre-Procedure Warfarin Management
Small skin and mucosal biopsies, neck masses, salivary gland and thyroid biopsies can be done safely without interruption of anticoagulation as 22-25 gauge needles are generally used.
If possible, a 3-5 day warfarin hold will minimize bruising and hematoma potential.
Safety of ultrasound-guided fine needle aspiration biopsy of neck lesions in patients taking antithrombotic/anticoagulant medications. Abu-Yousef MM, Larson JH, Kuehn DM, Wu AS, Laroia AT. Ultrasound Q. 2011 Sep;27(3):157-9.
Special thanks to
Charles Choe, MD and
Kevin Brumund, MD for their expert guidance.