IR Periprocedural Anticoagulation Clearance
Guideline-based anticoagulation and antiplatelet clearance using the SIR 2019 Consensus Guidelines. Procedure risk tier, lab targets, hold/restart timing, drug interactions, and clinical warnings.
What this tool does
IR Anticoag turns the SIR 2019 consensus tables into a bedside workflow for the full procedural timeline: pre-procedure hold planning, day-of clearance (labs + risk context), and post-procedure restart timing.
Why it exists
Periprocedural anticoag management is high-frequency, high-friction work:
- —The guideline is long, fragmented, and time-consuming to reference mid-day
- —Nuanced cases (elderly, high bleeding risk, CLD) get applied inconsistently
- —Overly conservative holds delay procedures and increase thrombotic risk
This tool reduces lookup time and standardizes the logic — without replacing clinical judgment.
Core workflow (3 phases)
Phase 1: Pre-planning
Select the procedure and antithrombotics and get hold timing that accounts for context (including renal function where relevant).
Phase 2: Clearance
Day-of go/no-go assessment with traffic-light output (met / caution / stop), missing-lab detection, and CLD-specific thresholds.
Phase 3: Post-procedure
Restart timing guidance based on procedure risk and what happened (e.g., traumatic access or bleeding).
What it covers
- —200+ IR procedures mapped to SIR risk tiers
- —30+ antithrombotic agents (DOACs, antiplatelets, reversal/hemostatic agents)
- —CLD pathway with prompts for platelets and fibrinogen
- —Bleeding-risk flags (e.g., HAS-BLED-style factors) to support conservative targets
- —Interaction and supplement screening
- —Mobile-first and offline-friendly (PWA)
Data handling
Runs client-side in your browser. Do not enter patient identifiers. Session state uses browser storage and can be cleared at any time.
Frequently Asked Questions
What guidelines does this tool use?
This tool implements the SIR 2019 Consensus Guidelines for Periprocedural Management of Thrombotic and Bleeding Risk (Parts I and II). Procedure risk tiers follow SIR Table 3, lab thresholds follow SIR Tables 2–4, and medication hold/restart timing follows SIR Table 6.
Does this tool replace clinical judgment?
No. This is clinical decision support only. The ultimate judgment regarding any specific procedure must be made by the treating physician, considering the individual patient, practice setting, and available resources.
Does it store or transmit patient data?
No. The tool runs entirely in your browser. Do not enter patient identifiers. No data is sent to any server. Session state uses browser localStorage and can be cleared at any time.
How are procedures classified by risk?
SIR uses a 2-tier system (low and high bleeding risk). Procedures explicitly listed in SIR Table 3 use those classifications. Procedures not listed use GigHz clinical mapping with conservative defaults, clearly labeled in the tool.
What about cirrhosis or chronic liver disease?
When cirrhosis/CLD is selected, the tool switches to SIR Table 4 thresholds. Standard coagulation parameters do not reliably predict bleeding risk in CLD. The tool adds fibrinogen to required labs and uses CLD-specific platelet and INR targets.
Found a bug or have a suggestion? We build tools for specific IR workflow challenges.
Send FeedbackWritten and reviewed by Pouyan Golshani, MD, Interventional Radiologist — Last updated February 15, 2026