Antiplatelet and anticoagulant agents

Numerous antithrombotic agents have been developed and approved for use in patients at risk for recurrent venous and arterial thromboembolism. Currently, the treatment options for anticoagulation extend beyond the conventional vitamin K antagonists and antiplatelet agents and now increasingly include direct oral anticoagulants (DOACs). While DOACs provide increased convenience to the patient, they present unique challenges in the management of patients who experience bleeding or those who require urgent surgery. This chapter examines the strategies available for reversal and perioperative management of patients on various antithrombotic agents and discusses the limitations and controversies associated with the available reversal strategies.