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Some practitioners are reluctant to perform joint aspiration or injection procedures in anticoagulated patients because of heightened risk for bleeding. Studies have shown that this risk is low (≤0.2%) in patients with international normalized ratios (INRs) between 2.0 and 3.0 who take warfarin, but risk for bleeding in patients who take direct-acting oral anticoagulants (DOACs) has not been reported. In this retrospective review of medical records, Mayo Clinic researchers assessed bleeding complications in 483 patients who took DOACs (i.e., rivaroxaban [Xarelto], apixaban [Eliquis], and dabigatran [Pradaxa]) and who underwent a total of 1050 arthrocentesis procedures or joint or bursa injections during a 6-year period.
In 22% of procedures,…