Many patients presenting for vascular procedures are on systemic anticoagulation or antiplatelet agents. ASRA has guidelines for the recommended interval for discontinuation of these agents prior to neuraxial placement and removal. They also make recommendations for appropriate intervals for resuming these agents while an epidural catheter is in place. ASRA recommends a 1-hour interval between needle placement and intraoperative heparinization.

There is less evidence on bleeding complications in patients receiving plexus or peripheral nerve blocks. The current ASRA recommendation is for patients undergoing perineuraxial, deep plexus, or deep peripheral nerve blocks to be managed according to neuraxial guidelines. They recommend that other blocks be managed according to site compressibility, vascularity, and impact if bleeding did occur. ASRA does not specifically define what is considered a superficial versus deep peripheral block but the European Society of Regional Anesthesia (ESRA) categorizes common blocks as superficial or deep. Arteriovenous fistula creation and lower limb amputation are common vascular procedures that receive peripheral nerve blocks. For upper extremity nerve blocks, the ESRA classifies the infraclavicular block as a deep nerve block. For lower extremity blocks, proximal sciatic blocks such as transgluteal are considered deep nerve blocks.