Anticoagulation Clearance — SIR 2019 Bedside Workflow for IR

What it does

A mobile-first clinical decision support tool that converts the SIR 2019 anticoagulation consensus guidelines into an interactive bedside workflow, covering three separate moments in the periprocedural sequence: hold planning before the case, day-of clearance from labs, and restart timing after.

The three stages

• Pre-plan: procedure plus medication list produces a hold schedule.
• Clear: labs produce a traffic-light clearance, with missing-data detection so a blank is never read as normal.
• Restart: timing guidance adjusted for complications and for the consequence of a rebleed.

What it encodes

• 200+ procedures mapped to SIR risk tiers, low versus high bleeding risk.
• 30+ antithrombotic agents, each carrying its own hold and restart logic.
• Chronic liver disease specific thresholds and prompts for platelets and fibrinogen, rather than generic cutoffs applied to a population they do not fit.
• Spectrum-style context for lab values instead of a bare pass or fail line.
• Drug interaction and supplement screening inside the medication step.

Why it exists

IR teams answer the same anticoagulation questions all day. The guideline is comprehensive but slow to consult in real time, and the result of that friction is inconsistent application and holds that are longer than they need to be.

Technical and scope

Runs entirely in-browser as a PWA, offline-friendly after first load, single-page, no backend calls required for the core workflow. No login, and no patient identifiers collected.

The tool encodes the SIR 2019 consensus edition. Confirm the current SIR guidance before relying on it. Informational only, and not medical advice.

For educational reference only. Clinical decisions require the physician's judgment of the individual patient. This tool supports that judgment; it does not replace it.

Written and reviewed by Pouyan Golshani, MD — February 2026