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Risk of Gastrointestinal Endoscopic Procedure-Related Bleeding in Patients With or Without Continued Antithrombotic

Kiyoaki Yabe1,2, Akira Horiuchi3, Takahiro Kudo1,4

  • 1Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane, 399-4117, Japan.

Digestive Diseases and Sciences
|June 20, 2020
PubMed

Insights

The risk of delayed bleeding after endoscopic procedures like EGD and colonoscopy with biopsy or cold snare polypectomy (CSP) is low, even when patients continue antithrombotic therapy. This study found minimal bleeding complications, suggesting safety for patients on these medications.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Cardiology

Background:

  • Prospective studies assessing bleeding risk during or after gastrointestinal endoscopic procedures are infrequent.
  • Antithrombotic therapy is commonly prescribed, necessitating an understanding of its impact on endoscopic procedure safety.

Purpose of the Study:

  • To investigate the risk of endoscopic procedure-related bleeding in patients undergoing biopsy and/or cold snare polypectomy (CSP).
  • To evaluate this risk in relation to the continuation of antithrombotic therapy.

Main Methods:

  • A prospective, observational, single-center cohort study (NCT02594813) was conducted.
  • Patients undergoing diagnostic esophagogastroduodenoscopy (EGD) or colonoscopy were enrolled.
  • The primary outcome was delayed bleeding requiring endoscopic treatment within two weeks post-procedure.

Main Results:

  • In 3069 EGD patients on antithrombotic therapy, no delayed bleeding occurred; immediate bleeding was 6.4% with biopsy.
  • In 1116 colonoscopy patients on antithrombotic therapy, delayed bleeding occurred in 1.3% after CSP; immediate bleeding was 4% after biopsy and 14% after CSP.
  • Chronic kidney disease and CSP were significantly associated with bleeding risk in patients on antithrombotic agents.

Conclusions:

  • The risk of delayed bleeding following diagnostic EGD with biopsy or colonoscopy with biopsy and/or CSP is low.
  • Continuation of antithrombotic therapy appears safe for these endoscopic procedures, with minimal delayed bleeding risk observed.
Abstract

Keywords:
Antithrombotic agentsCold snare polypectomyColonoscopyEsophagogastroduodenoscopyMucosal biopsy

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