Preexisting dual antiplatelet therapy (DAPT) (ASA + thienopyridine)

Discontinue thienopyridine, continue ASA.

Be prepared for major intraoperative bleeding. Order packed red blood cells and platelet concentrates.

Be sure anesthesiology is also prepared. Neuraxial blockade is contraindicated.

Do not delay surgery longer than necessary. Take care of meticulous intraoperative hemostasis and be aware of potential postoperative hematoma formation. Resume thienopyridine as soon as possible (6–24 h postoperatively).