The development of thrombo-embolic events may happen when we withdraw antithrombotic agents for surgery, and bleeding becomes a big issue when it continues. As for the extraction of a tooth and the cataract surgery, antithrombotic agents should be continued. However, it is usually discontinued at major surgery or operation under the endoscope. Alternative therapy with heparin is acceptable for patients with high risk factors of thrombo-embolic events when atithrombotic agents is discontinued. Because, we can not remove any risk of thrombo-embolic evetns by the alternative therapy, informed consent is required when antithrombotic agents is discontinued.
