LAUSR

BACKGROUND Direct oral anticoagulants (DOACs) i.e. apixaban, rivaroxaban, and dabigatran are increasingly being utilized to provide prophylaxis and treatment for arterial and venous thromboembolism. While multiple procedural subspecialties have implemented guidelines detailing timeframes for perioperative DOAC interruption, the impact of perioperative DOAC interruption in patients undergoing dermatologic surgery is currently unknown, and evidence-based guidelines are lacking. OBJECTIVE To assess the 30-day postoperative rate of thrombotic complications (ischemic stroke, transient ischemic attack [TIA], systemic embolism, deep vein thrombosis [DVT] and pulmonary embolism) in patients with nonvalvular atrial fibrillation (AF) or a history of DVT who underwent perioperative DOAC interruption during dermatologic surgery. MATERIALS & METHODS A retrospective chart review was performed of all patients with AF or a history of DVT who underwent perioperative DOAC interruption during dermatologic surgery at Advanced Dermatologic Surgery and the University of Kansas Medical Center between January 1, 2016 and August 31, 2020 RESULTS: Among 806 surgeries (750 [93.1%] Mohs surgeries, 56 [6.9%] excisions), 1 case (0.14% of patients with AF) sustained a TIA and 2 cases (0.25% of all patients) sustained minor bleeding complications during the 30-day postoperative period. CONCLUSION Perioperative DOAC interruption appears to be safe and efficacious in dermatologic surgery.