Direct oral anticoagulant use for treatment of venous thromboembolism and nonvalvular atrial fibrillation after bariatric surgery
| Gastric banding | All direct oral anticoagulants can be used because the gastrointestinal anatomy is preserved |
| Gastric sleeve | Apixaban may be a preferred option because of the intact duodenum; avoid rivaroxaban and dabigatran because they are predominantly absorbed in the stomach; edoxaban requires an acidic environment for optimal absorption, which may be altered |
| Roux-en-Y gastric bypass Biliopancreatic diversion with duodenal switch | All direct oral anticoagulants should be avoided due to inadequate absorption after extensive loss of the stomach and proximal small intestines |