Endoscopy in patients with anticoagulant and antiplatelet therapy

Authors: Z. Zádorová
Authors‘ workplace: II. interní klinika FNKV, 3. LF UK v Praze
Published in: Gastroent Hepatol 2012; 66(5): 384-389


The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

15. 4. 2012

24. 6. 2012


1. Anderson MA, Ben-Menachem T, Gan SI et al. Management of antithrombotic agents for endoscopic procedures. Gastro­intest Endosc 2009; 70(6): 1060–1070.

2. American Society for Gastrointestinal endo­scopy. ASGE Standards of Practice Committee. (www.asge.org).

3. Al-Haddad M, Gill KR, Raimondo M et al. Safety and efficacy of cytology brushings versus standard fine-needle aspiration in evaluating cystic pancreatic le­sions: a controlled study. Endoscopy 2010; 42(2): 127–132.

4. Ansell J, Hirsch J, Poller L et al. The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126 (Suppl 3): 204S–233S.

5. Blacker DJ, Wijdicks EFM, McClelland RL. Stroke risk in anticoagulated patients with atrial fibrillation undergoing endoscopy. Neurology 2003; 61(7): 964–968.

6. Boustiere C, Veitch A, Vanbiervliet G et al. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endo­scopy (ESGE) guideline. Endoscopy 2011; 43(5): 445–458.

7. Cannegieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart valve prosthesis. Circulation 1994; 89(2): 635–641.

8. Cao Y, Liao C, Tan A et al. Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract. Endoscopy 2009; 41(9): 751–757.

9. Cappell MS, Abdullah M. Management of gastrointestinal bleeding induced by gastro­intestinal endoscopy. Gastroenterol Clin North Am 2000; 29(1): 125–167.

10. Cho-S-J, Choi IJ, Kim CG et al. Aspirin use and bleeding riskafter endoscopic submucosal dissection in patients with gastric neoplasms. Endoscopy 2012; 44(2): 114–121.

11. Choudari CP, Rajgopal C, Palmer KR. Acute gastrointestinal haemorrhage in anticoagulated patiens: diagnosis and response to Endoscopic treatment. Gut 1994; 35(4): 464–466.

12. Coronel M, Banner K, Nannegari V et al. Does aspirin increase the risk of bleeding for percutaneous endoscopic gastrostomy procedure? Gastrointest Endosc 2006; 63: AB113.

13. Cotton PB, Lehman G, Vennes J et al. Endoscopic sphincterotomy complica­tions and their management: an attempt at consensus. Gastrointest Endosc 1991; 37(3): 383–393.

14. Friedland S, Sedehi D, Soetikno R. Colonoscopic polypectomy in anticoagulated patients. World J Gastroenterol 2009; 15(16): 1973–1976.

15. Dumonceau J-M, Andriulli A, Deviere J et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy 2010; 42(6): 503–515.

16. Garcia DA, Regan S, Henault LE et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med 2008; 168(1): 63–69.

17. Gershlick AH, Richardson G. Drug eluting stents. BMJ 2006; 333(7581): 1233–1234.

18. Gerson LB, Gage BF, Owens DK et al. Effect and outcomes of the ASGE guidelines on the periendoscopic management of patients who take anticoagulants. Am J Gastroenterol 2000; 95(7): 1717–1724.

19. Gerson LB, Tokar J, Chiorean M et al. Complications associated with double balloon enteroscopy at nine US centers. Clin Gastro­enterol Hepatol 2009; 7(11): 1177–1182.

20. Guidelines of the French Society for Digestive Endoscopy (SFED). Management of Patients on Anticoagulants or Antiplatelet Agents before Digestive Endoscopy. Endo­scopy 2006; 38: 632–638.

21. Harrison RW, Ortel TL, Becker RC. To bridge or not to bridge: these are the questions. J Tromb Trombolysis; DOI 10.1007//s11239-012-0732-8.

22. Heresbach D, Kornhauser R, Seyrig JA et al. A national survey of endoscopic mucosal resection for superficial gastro­intestinal neoplasia. Endoscopy 2010; 42(10): 806–813.

23. Hui AJ, Wong RM, Ching JY et al. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointest Endosc 2004; 59(1): 44–48.

24. Hui CK, Lai KC, Yuen MF et al. Does withholding aspirin for one week reduce the risk of post-sphincterotomy bleeding? Aliment Pharmacol Ther 2002; 16(5): 929–936.

25. Hussain N, Alsulaiman R, Burtin P et al. The safety of endoscopic sphincterotomy in patients receiving antiplatelet agents: a case-control study. Aliment Pharmacol Ther 2007; 25(5): 579–584.

26. Iakovou I, Schmidt T, Bonizzoni E et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 2005; 293(17): 2126–2130.

27. Irani S, Arai A, Ayub K et al. Papillectomy for ampullary neoplasm: results of a single referral center over a 10-year period. Gastro­intest Endosc 2009; 70(5): 923–932.

28. King SB 3rd, Smith SC Jr, Hirshfeld JW Jr et al. 2007 focused update of the ACC//AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol 2008; 51(2): 172–209.

29. Kouklakis G, Mpoumponaris A, Gato­poulou A et al. Endoscopic resection of large pedunculated colonic polyps and risk of postpolypectomy bleeding with adrenaline injection versus endoloop and hemoclip: a prospective, randomized study. Surg Endosc 2009; 23(12): 2732–2737.

30. Kwan V, Bourke MJ, Williams SJ et al. Argon plasma coagulation in the management of symptomatic gastrointestinal vas­cular lesions: experience in 100 consecutive patients with long-term follow-up. Am J Gastroenterol 2006; 101(1): 58–63.

31. Malik P, Yamashita B, Larson L et al. Comparison of various periprocedure anticoagulation approaches for elective colono­scopy: a cost modeling study. Gastro­intest Endosc 1999; 49: AB197.

32. Metman EH, Lagasse JP, d’Alteroche L et al. Risk factors for immediate complications after progressive pneumatic dilation for achalasia. Am J Gastroenterol 1999; 94(5): 1179–1185.

33. Okada K, Yamamoto Y, Kasuga A et al. Risk factors for delayed bleeding after endo­scopic submucosal dissection for gastric neoplasm. Surg Endosc 2011; 25(1): 98–107.

34. Ono S, Fujishiro M, Niimi K et al. Technical feasibility of endoscopic submucosal dissection for early gastric cancer in patients taking anti-coagulants or anti-­platelet agents. Dig Liver Dis 2009; 41(10): 725–728.

35. Penka M, Gumulec J, Bulíková A et al. Monitorování perorální antikoagulační léčby v ambulantní praxi. Kardiol Rev 2007; 9(3): 159–164.

36. Remedia Compendium. Panax 1999. www.panax.cz.

37. Richter J, Patrie J, Richter R et al. Use of high-dose aspirin or clopidogrel before or after percutaneous endoscopic gastro­stomy is not associated with post-procedural bleeding. Gastrointest Endosc 2010; 71: AB114.

38. Ruthmann O, Seitz A, Richter S et al. Percutaneous endoscopic gastrostomy. Complications with and without anticoagulation. Chirurg 2010; 81(3): 247–254.

39. Sawhney MS, Salfiti N, Nelson DB et al. Risk factors for severe delayed postpolypectomy bleeding. Endoscopy 2008; 40(2): 115–119.

40. Sendino O, Fernández-Esparrach G, Solé M et al. Endoscopic ultrasonography- guided brushing increases cellular diagnosis of pancreatic cysts: A prospective study. Dig Liver Dis 2010; 42(12): 877–881.

41. Singh M, Mehta N, Murthy UK et al. Postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel therapy. Gastrointest Endosc 2010; 71(6): 998–1005.

42. Shiftman ML, Farrel MT, Yee YS. Risk of bleeding after endoscopic biopsy or polypectomy in patiens taking aspirin or other NSAIDs. Gastrointest Endosc 1994; 40(4): 458–462.

43. Stein RD, Alpert IS, Copeland J et al. Antithrombotic therapy in patients with mechanical and biological prosthetic heart valves. Chest 1992; 102 (4 Suppl): 445s–455s.

44. Thomas T, Bebb J, Mannath J et al. ­EUS-guided pancreatic cyst brushing: a comparative study in a tertiary referral centre. JOP 2010; 11(2): 163–169.

45. Tsuji Y, Ohata K, Ito T et al. Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions. World J Gastro­enterol 2010; 16(23): 2913–2917.

46. Veitch AM, Baglin TP, Gershlick AH et al. Guidelines for the management of anticoagulant and antiplatelet therapy in patients undergoing endoscopic procedures. Gut 2008; 57(9): 1322–1329.

47. Wang MQ, Sze DY, Wang ZP et al. Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol 2001; 12(4): 465–474.

48. Williams DO, Abbott JD, Kip KE. DEScover Investigators. Outcomes of 6906 pa­tients undergoing percutaneous coronary intervention in the era of drug-eluting stents: report of the DEScover Registry. Circulation 2006; 114(20): 2154–2162.

49. Yousfi M, Gostout CJ, Baron TH et al. Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. Am J Gastroenterol 2004; 99(9): 1785–1789.

Paediatric gastroenterology Gastroenterology and hepatology Surgery

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