[Invasive procedures and long-term anti-coagulation: to bridge or not to bridge?].

Long-term oral anticoagulation is prescribed to 1% of the population to lower thrombotic risk associated with venous thromboembolic disease (VTD), atrial fibrillation (AF), and cardiac mechanical valve. Annually, 10% of patients with at least one of these conditions undergo an invasive procedure. In such case, bridging anticoagulation with short half-life parenteral molecules is frequently performed to lower the peri-procedural thrombotic risk. Nevertheless, available evidence suggests an increase bleeding risk is associated with the bridging procedure and recommendations regarding bridging are followed in less than one third of cases. Bridging should be considered only if the thromboembolic risk is high such as recent VTD (< 3 months), AF with past history of stroke or transient ischemic attack, and cardiac mechanical valve.