Should xarelto be held for this low risk skin excision?

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I have a 44 year old M with basal cell carcinoma on his R shoulder. Plan is for surgical excision in two weeks. He is currently on xarelto 20 mg PO qD. Do I need to hold anticoagulation preop for this low risk procedure in an otherwise low risk patient. Lesion is about 2cm in diameter with plan to do full thickness excision in hospital in the OR.

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I am answering from a plastic surgeon’s perspective. In general, it all depends on the indication for Xarelto. Low risk for using the medication means that it could likely be discontinued.  If there is a high risk for an event by stopping the medication, then one should think twice about discontinuing it. Other options could be considered for treatment including radiation therapy. However if the patient and surgeon feel surgery is the best option, then the benefits and risks will have to be weighed. Even though it is a minor procedure, there is always a small risk of bleeding. Xarelto has a rather short half-life, so it could potentially be discontinued a day or two prior to the procedure and started up again the following day after the procedure. Hope this helps.

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