Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

By S. Schulman, R. Beyth, C. Kearon, M. Levine. Chest, 2008

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Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition) (2009, background): “5.2 We recommend against the concurrent use of medications that affect other components of the clotting mechanisms and may increase the risk of bleeding complications for patients receiving oral anticoagulants and do so without inﬂuencing the INR.”
Efficacy and Safety of a 4-Factor Prothrombin Complex Concentrate in Patients on Vitamin K Antagonists Presenting With Major Bleeding A Randomized, Plasma-Controlled, Phase IIIb Study (2013, background): “4%.(2) Furthermore, there are >60,000 annual emergency department visits for hemorrhagic complications in VKA-treated patients.”
Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) (2018, background): “However, combination therapy with UFH, LMWH, oral anticoagulants, and thrombolytics has been demonstrated to increase the frequency of spontaneous hemorrhagic complications, bleeding at puncture sites, and spinal hematoma.(2,50,79) For example, in the series of 40 spinal hematomas associated with LM”