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Table 4 Management of bleeding risk factors before image-guided percutaneous lung ablation

From: Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

Pre-procedure laboratory testing and management  
INR: routinely recommended. Correct to < 1.5  
aPTT: routinely recommended in patients receiving UFH. Stop or reverse UFH for values > 1.5 × control  
Platelet count: routinely recommended. < 50,000: transfuse  
Hematocrit: routinely recommended. No recommended threshold for transfusion  
Anticoagulant and antiplatelet management  
Clopidogrel: withhold for five days before procedure. Resume the day after procedure  
Aspirin: withhold for 3–5 days before procedure. Resume the day after procedure  
LMWH: withhold for 24 h or up to two doses. Resume the 12 h after procedure  
Warfarin: Withhold five days until target INR < 1.5; consider bridging for high thrombosis risk cases. Resume the day after procedure  
  1. INR international normalized ratio, aPTT activated partial thromboplastin time, UFH unfractionated heparin, LMWH low-molecular-weight heparin