Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence
Autor: | Hamish Philpott, Amanda H Lim, Derrick Tee, Biju George, Damian Harding, Rajvinder Singh, Andrew Chan, Mohamed A. Chinnaratha, Minnie Au |
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Rok vydání: | 2020 |
Předmět: |
Gastrointestinal
medicine.medical_specialty Gastrointestinal bleeding medicine.drug_class medicine.medical_treatment Context (language use) Review 03 medical and health sciences Patient safety 0302 clinical medicine medicine Antiplatelets Intensive care medicine Gastrointestinal endoscopy medicine.diagnostic_test business.industry Bleeding Anticoagulant Warfarin Anticoagulants Endoscopy medicine.disease Polypectomy Antithrombotics 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business medicine.drug |
Zdroj: | World Journal of Gastrointestinal Endoscopy |
ISSN: | 1948-5190 |
Popis: | The role of endoscopic procedures, in both diagnostic and therapeutic purposes is continually expanding and evolving rapidly. In this context, endoscopists will encounter patients prescribed on anticoagulant and antiplatelet medications frequently. This poses an increased risk of intraprocedural and delayed gastrointestinal bleeding. Thus, there is now greater importance on optimal pre, peri and post-operative management of anticoagulant and/or antiplatelet therapy to minimise the risk of post-procedural bleeding, without increasing the risk of a thromboembolic event as a consequence of therapy interruption. Currently, there are position statements and guidelines from the major gastroenterology societies. These are available to assist endoscopists with an evidenced-based systematic approach to anticoagulant and/or antiplatelet management in endoscopic procedures, to ensure optimal patient safety. However, since the publication of these guidelines, there is emerging evidence not previously considered in the recommendations that may warrant changes to our current clinical practices. Most notably and divergent from current position statements, is a growing concern regarding the use of heparin bridging therapy during warfarin cessation and its associated risk of increased bleeding, suggestive that this practice should be avoided. In addition, there is emerging evidence that anticoagulant and/or antiplatelet therapy may be safe to be continued in cold snare polypectomy for small polyps (< 10 mm). |
Databáze: | OpenAIRE |
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