AF Association
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Hi all,

I am to have a nasendoscopy to see if there is any other reason than the warfarin for some spitting of blood in the mornings only.

Has anyone had this procedure and if so did you have to stop warfarin a few days before?

Anyone having this or any other procedure how did you get on stopping and starting warfarin again. I am concerned about the rebound effect risk of clots forming.

Thanks to everyone you are an amazing bunch.


3 Replies

No problem stop/start warfarin when attending clinic for management.


I have done a little googling. A pity there is not a one stop website for questions like this, a website that highlights the different opinions and options.

If you only have AF, the risk of reducing INR (to for example less than 2, which can usually be done in 2-4 days) is very low. See:

AF patients probably do not need "bridging therapy" ie admission to hospital, they put you on a drip of a short acting anticoagulant, stop it an hour before the op, restore it soon after and restart warfarin, and release you when your INR based on warfarin is in range. This is the traditional method, and it has many many problems, and if I were advised it I would question it. More and more operations are now done without bridging, including surgery to remove a tooth that is fused to the jaw. I know from experience.

If you have an artificial heart valve, that is another question.

epistaxis is nose bleeed. Here is a quote: "There is usually no benefit in stopping the warfarin or aspirin of any patients whose bleeding stops with simple measures or an anterior pack.

If epistaxis is torrential, ie not responsive to anterior packing, then consider reversing anticoagulation."

Therefore, since the nose is relatively accessible, and it is comparable to having a tooth out, I would argue for the operation with INR less than 4.0. The surgeon will know there is a higher risk of bleeding and will act accordingly.


I had colonoscopy (I know not the same but maybe similar ) and did not have to stop warfarin.


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