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Updated: Jun 23, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
[IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy]
Seung Joo Kang1, Chung Hyun Tae2, Chang Seok Bang3
1Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Insights
This guideline offers updated recommendations for managing patients on antithrombotic agents during endoscopic procedures. It addresses new evidence on dual antiplatelet therapy and anticoagulants for safer patient care.
Area of Science:
- Gastroenterology and Cardiology
- Clinical Practice Guidelines
Background:
- Antithrombotic agents are increasingly used in Korea due to rising cardio-cerebrovascular disease and an aging population.
- Managing patients on these agents during endoscopic procedures presents a clinical challenge.
- Previous guidelines from 2020 require updates due to new evidence and international revisions.
Purpose of the Study:
- To revise and update clinical practice guidelines for managing patients on antithrombotic therapy undergoing endoscopy.
- To incorporate recent evidence on dual antiplatelet therapy and direct anticoagulants.
- To provide evidence-based recommendations for endoscopists.
Main Methods:
- Revision of existing guidelines based on new evidence.
- Inclusion of cardiologists and international experts in the development group.
- Application of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
- Consensus process among multidisciplinary experts.
Main Results:
- Development of 14 revised recommendations.
- Guideline reviewed by multidisciplinary experts.
- Provides actionable information for endoscopists managing patients on antithrombotic agents.
Conclusions:
- The revised guideline assists endoscopists in managing patients on antithrombotic agents during diagnostic and therapeutic endoscopy.
- It incorporates the latest evidence and expert consensus.
- The guideline will be updated as new evidence emerges.
Abstract:
Antithrombotic agents, including antiplatelet agent and anticoagulants are widely used in Korea due to increasing incidence of cardio-cerebrovascular disease and aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. Clinical practice guideline regarding this issue which was developed by the Korean Society of Gastrointestinal Endoscopy was published in 2020. However, since then, new evidence has emerged for the use of dual antiplatelet therapy and direct anticoagulant management, and revised guidelines were issued in the US and Europe. Accordingly, the previous guidelines were revised, cardiologists also participated in the development group, and the recommendations went through a consensus process among international experts. This guideline presents 14 recommendations made according to the Grading of Recommendations, Assessment, Development, and Evaluation methodology, and was reviewed by multidisciplinary experts. This guideline provides useful information that can assist endoscopists in the management of patients on antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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