Affordable Access

Publisher Website

Current guidelines for endoscopy in patients receiving antithrombotic medication

Authors
Journal
Gastrointestinal Intervention
2213-1795
Publisher
Elsevier
Volume
1
Issue
1
Identifiers
DOI: 10.1016/j.gii.2012.09.003
Keywords
  • Antiplatelet
  • Aspirin
  • Gastrointestinal Endoscopy
  • Thienopyridine
  • Warfarin Bleeding
Disciplines
  • Medicine

Abstract

Abstract Antiplatelet agents and anticoagulants make up the larger group of antithrombotic medications, which have seen increasing use worldwide as populations in developed countries age, and ischemic heart disease prevalence rises. Antithrombotic medications reduce the risk of thromboembolic events in susceptible individuals, but increase the risk of gastrointestinal bleeding. Cessation of antithrombotic drugs prior to endoscopic therapy has been proposed, aimed at reducing the risk of immediate and early bleeding. However, interruption of antithrombotic therapy is associated with cardiovascular risk. The peri-endoscopic management of patients at high thromboembolic risk therefore requires knowledge of both the bleeding risk associated with endoscopic procedures, and the potential risks of stopping antithrombotic therapy. Three major endoscopy organizations (British Society of Gastroenterology, American Society of Gastrointestinal Endoscopy & European Society of Gastrointestinal Endoscopy) have published guidelines aimed at providing a rational strategy for the endoscopist in managing the individual patient on antithrombotic medication. This article compares and contrasts the approach of each guideline, in an attempt at consensus. The British Society of Gastroenterology and American Society of Gastrointestinal Endoscopy guidelines address the use of both antiplatelet agents and anticoagulants during the peri-endoscopic period, while the European Society of Gastrointestinal Endoscopy guideline is focused solely on antiplatelet medication. The guidelines were formulated with reference mainly to observational studies and expert opinion, and therefore have a limited basis in evidence. A rational strategy is proposed for common scenarios encountered in gastrointestinal endoscopy, based on the published guidelines. Despite the existence of these guidelines, they serve at best as a framework for individualized management tailored to the patient’s particular clinical scenario.

There are no comments yet on this publication. Be the first to share your thoughts.

Statistics

Seen <100 times
0 Comments

More articles like this

Safety measures for gastrointestinal endoscopy in...

on Digestive endoscopy : official... January 2012

Guidelines for gastroenterological endoscopy in pa...

on Digestive endoscopy : official... January 2014

[Perioperative management of patients receiving lo...

on Anesteziologiia i reanimatolog... 2014

Guidelines for antithrombotic therapy in pediatric...

on The Journal of Pediatrics April 1998
More articles like this..