• Anesthesiology:
• low risk:
• endotracheal intubation
• peripheral catheter placement, nontunneled catheter (peripherally inserted central catheter) placement
• high risk: spinal and epidural anesthesia (potential for profound neurologic consequences)
• Cardiac surgery:
• low risk: none
• high risk: all
• Cardiovascular:
• low risk: diagnostic coronary angiography (controversial)
• high risk:
• pacemaker or defibrillator placement (potential for profound neurologic consequences): 3.5% on warfarin therapy, 16% with bridging anticoagulation (2)
• coronary intervention
• electrophysiology testing and/or ablation
• Dental:
• low risk: tooth extraction, endodontic procedures (root canal)
• high risk: reconstructive procedures
• Dermatology:
• low risk: minor skin procedures (excision of basal and squamous cell cancers, nevi, actinic keratoses, premalignant lesions)
• high risk: major procedures (wide excision of melanoma)
• Gastroenterology:
• low risk:
• passage of endoscope for diagnostic purposes (including balloon enteroscopy) with or without mucosal biopsy
• endoscopic retrograde cholangiopancreatography without sphincterotomy
• endoscopic ultrasound without fine-needle aspiration
• nonthermal (cold) snare removal of small polyps
• lumenal self-expanding metal stent placement (controversial)
• high risk: 
• large polypectomy (>1 cm)
• endoscopic mucosal and submucosal dissection
• biliary or pancreatic sphincterotomy
• percutaneous endoscopic gastrostomy
• endoscopic ultrasound with fine-needle aspiration or needle biopsy
• coagulation or ablation of tumors, vascular lesions
• percutaneous liver biopsy
• variceal band ligation (controversial): The risk of delayed bleeding following EVL (2.4 %-5.7 %) and sclerotherapy (4 %-25 %) is high (3,4).
• General surgery:
• low risk:
• suture of superficial wounds
• high risk:
• major tissue injury
• vascular organs (spleen, liver, kidney)
• bowel resection
• laparoscopy
• Gynecologic surgery:
• low risk:
• diagnostic colposcopy, hysteroscopy
• dilation and curettage, endometrial biopsy
• insertion of intrauterine device
• high risk:
• laparoscopic surgery
• bilateral tube ligation
• hysterectomy
• Interventional radiology:
• low risk:
• simple catheter exchange in well-formed, nonvascular tracts (e.g., gastrostomy, nephrostomy, cholecystostomy tubes)
• thoracentesis
• paracentesis
• aspiration of abdominal or pelvic abscesses, placement of small-caliber drains
• peripheral catheter placement, nontunneled catheter (peripherally inserted central catheter) placement
• inferior vena cava filter placement
• temporary dialysis catheter placement
• high risk:
• percutaneous transhepatic cholangiography or nephrostomy
• percutaneous drainage of liver abscess or gallbladder
• chest tube placement
• aggressive manipulation of drains or dilation of tracts
• biopsy of organs
• hickmann and tunneled dialysis catheter placement
• Intravascular procedures:
• low risk: venous access
• high risk:
• arterial puncture
• transvenous ablation
• Neurology:
• low risk: none
• high risk:
• lumbar puncture (potential for profound neurologic consequences)
• myelography
• needle electromyography (controversial)
• Neurosurgery:
• low risk: none
• high risk: intracranial, spinal surgery (potential for profound neurologic consequences)
• Ophthalmology:
• low risk:
• cataract surgery
• intraocular injections
• (Avoid retrobulbar anesthesia - controversial)
• high risk:
• periorbital surgery
• vitreoretinal surgery
• Orthopedic surgery:
• low risk: arthrocentensis
• high risk:
• joint replacement
• arthroscopy
• Otolaryngologic surgery:
• low risk:
• diagnostic fiberoptic laryngoscopy or nasopharyngoscopy, sinus endoscopy
• fine needle aspiration
• vocal cord injection
• high risk:
• any sinus surgery
• biopsy or removal of nasal polyps
• thyroidectomy
• parotidectomy
• septoplasty
• turbinate cautery
• Plastic surgery:
• low risk: injection therapy
• high risk: reconstruction
• Pulmonary:
• low risk:
• diagnostic bronchoscopy with or without bronchioalveolar lavage
• endobronchial fine-needle aspirate (controversial)
• airway stent placement (controversial)
• high risk:
• tumor ablation (laser)
• transbronchial biopsy
• stricture dilation
• Rheumatology
• low risk: arthrocentesis
• high risk: none
• Urology:
• low risk:
• circumcision
• cystoscopy without biopsy
• high risk:
• extracorporeal shock-wave lithotripsy
• transurethral prostatectomy
• bladder resection
• tumor ablation
• kidney biopsy
• Vascular surgery:
• low risk: none
• high risk:
• carotid endarterectomy
• open or endovascular aneurysm repair
• vascular bypass grafting

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