Risk of Delayed Bleeding after Cold Snare Polypectomy in Patients with Antithrombotic Therapy

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Patient Safety

Background:

• Cold snare polypectomy (CSP) adoption is increasing.
• Limited data exists on CSP safety in patients using antithrombotic therapy.

Purpose of the Study:

• To evaluate the real-world safety of CSP in patients undergoing antithrombotic therapy.
• To compare delayed bleeding rates between patients with and without antithrombotic therapy.

Main Methods:

• Retrospective analysis of 2152 patients undergoing CSP for polyps ≤10 mm between 2013-2017.
• Primary outcome: delayed bleeding. Risk factors analyzed using logistic regression.
• Comparison of bleeding rates in patients with vs. without antithrombotic therapy.

Main Results:

• Delayed bleeding occurred in 0.51% of patients (1.64% with antithrombotics vs. 0.37% without, p=0.009).
• No major delayed bleeding was observed.
• Significant risk factors for bleeding included larger polyp size (>5 mm), clip use, and antithrombotic therapy.

Conclusions:

• Delayed bleeding after CSP is rare, even for patients on antithrombotic therapy.
• No major bleeding complications were recorded, supporting CSP safety in this population.