High risk
Neurosurgery (intracranial or spinal surgery)
Cardiac surgery (coronary artery bypass or heart valve replacement)
Major vascular surgery (abdominal aortic aneurysm repair, aortofemoral bypass)
Major urologic surgery (prostatectomy, bladder tumour resection)
Major lower limb orthopaedic surgery (hip/knee joint replacement surgery)
Lung resection surgery
Intestinal anastomosis surgery
Selected invasive procedures (kidney biopsy, prostate biopsy, cervical cone biopsy, pericardiocentesis, colonic polypectomy or biopsies)
Intermediate risk
Other intra-abdominal surgery
Other intrathoracic surgery
Other orthopaedic surgery
Other vascular surgery
Low risk
Laparoscopic cholecystectomy
Laparoscopic inguinal hernia repair
Dental procedures
Dermatologic procedures
Ophthalmologic procedures*
Coronary angiography
Gastroscopy or colonoscopy
Selected invasive procedures (bone marrow aspirate and biopsy, lymph node biopsy, thoracentesis, paracentesis, arthrocentesis)
Cardiac implantable device surgery (pacemaker or implantable defibrillator)†
Very low risk
Dental extractions (1 or 2 teeth) or teeth cleaning
Skin biopsy or skin cancer removal
Cataract removal

* Selected ophthalmic procedures might be high risk such as those with retrobulbar block.

† Based on results from the Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial (BRUISECONTROL) trial.1

1. Birnie DH, Healey JS, Wells GA, et al. Pacemaker or defibrillator surgery without interruption of anticoagulation. N Engl J Med 2013;368:2084-93.