What is the perioperative approach to those patients who are APL positive without a history of blood clots?
The concern is that surgery and its postoperative issues may tip a person with a potential predisposition to clot into a hypercoagulable state where a clinically apparent clot develops. There is a general consensus to apply standard perioperative DVT prophylaxis approaches that are used in general populations; however, there is controversy on whether to continue prophylactic anticoagulation after discharge and regarding duration of therapy. Some experts advocate for the continuation of prophylactic doses of LMWHs or therapeutic warfarin for 1 to 6 weeks postoperatively (including patients in the postpartum period).
