Continuation of antithrombotic therapy may be associated with a high incidence of colonic post‐polypectomy bleeding

Shibuya, Tomoyoshi; Nomura, Osamu; Kodani, Tomohiro; Murakami, Takashi; Fukushima, Hirofumi; Tajima, Yuzuru; Matsumoto, Keīichi; Ritsuno, Hideaki; Ueyama, Hiroya; Inami, Yoshihiro; Ishikawa, Dai; Matsumoto, Kenshi; Sakamoto, Naoto; Osada, Taro; Nagahara, Akihito; Ogihara, Tatsuo; Watanabe, Sumio

doi:10.1111/den.12760

Cited by 13 publications

(22 citation statements)

References 32 publications

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“…Consistent with this finding, the use of anticoagulants or antiplatelet agents is considered to promote POB in patients treated with EP or EMR [18][19][20] . Thus, the use of anticoagulants or antiplatelet agents increases the risk of POB following EMR, EP, and ESD.…”

Section: Discussionmentioning

confidence: 62%

“…Previous studies showed that multiple factors such as size, pedunculated form, and proximal location increase the rate of POB following EP [19,25,26] . In addition, antithrombotic therapy, hypertension, chronic renal disease, cardiovascular disease, and advanced age were identified as patient-associated risk factors for delayed bleeding [18][19][20] . Based on these previous reports, we performed a univariate analysis of the clinical parameters in this retrospective study.…”

Section: Risk Factors For Pob Following Colorectal Esdmentioning

confidence: 99%

“…Although antithrombotic therapy is effective for the prevention of ischemic cardiovascular events, the recent use of anticoagulants or antiplatelet agents is considered a major risk factor for POB following EP and EMR [18][19][20] . According to the recent guidelines of the Japan Gastroenterological Endoscopic Society (JGES), anticoagulants or antiplatelet agents should not be discontinued before endoscopic procedures with low risk of bleeding since the withdrawal of these drugs may cause new-onset cardiovascular events [21] .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Okamoto¹,

Watanabe²,

Komeda³

et al. 2017

Oncology

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antithrombotic therapy and rectal tumor location were strongly associated with POB following colorectal ESD. The incidence of POB was higher in patients on heparin bridge therapy (HBT) for the replacement of antithrombotic therapy than in patients with no HBT. Four of 7 patients (57.1%) on antithrombotic therapy experienced POB from the rectal lesions. Conclusion: Antithrombotic therapy and rectal lesions result in a higher POB incidence after colorectal ESD.

show abstract

Section: Discussionmentioning

confidence: 62%

Section: Risk Factors For Pob Following Colorectal Esdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Okamoto¹,

Watanabe²,

Komeda³

et al. 2017

Oncology

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“…Among the antithrombotic agents, HB therapy has been reported to be a strong risk factor for PPB [7,15,30,31]. Ishigami et al [31] reported that the OR of PPB in patients treated with HB was 9.8 compared with that of patients without antithrombotic treatment.…”

Section: Discussionmentioning

confidence: 99%

“…PPB risks associated with each type of antithrombotic, such as aspirin, thenopyridine, warfarin, or heparin, have been reported [7,[9][10][11][12][13][14][15], and several guidelines have been published regarding possible management modalities [16][17][18][19][20][21]. In contrast, the number of patients treated with multiple antithrombotics, such as dual antiplatelet therapy, is also increasing [22,23], but little is known about the PPB risk in patients receiving multiple antithrombotic agents.…”

Section: Introductionmentioning

confidence: 99%

Risk Analysis of Colorectal Post-Polypectomy Bleeding Due to Antithrombotic Agent

et al. 2018

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Background/Aims: Post-polypectomy bleeding (PPB) is a major complication of colorectal polypectomy, and antithrombotics is one of the major risk factors of PPB. The purpose of this study was to investigate PPB risks with regard to the combinations of antithrombotic agents used. Methods: We retrospectively reviewed cases involving colonoscopic polyp resection between September 2002 and December 2014. The risk of PPB was assessed according to patient and lesion factors, including antithrombotic use. Antithrombotics were discontinued before polypectomy. Results: A total of 6,382 colonoscopies with 12,876 polypectomies were analyzed. PPB occurred in 55 patients (0.9%) and 63 lesions (0.5%). Among patients treated with antithrombotics, heparin bridging (HB) therapy was an independent risk factor of PPB (per patient, 20%, OR 33.1, p < 0.001; per lesion, 9.1%, OR 17.3, p < 0.001) compared to those without antithrombotics (per patient 0.7%; per lesion 0.4%). Among patients without HB, the combination of anticoagulant + antiplatelet agents was significantly associated with PPB (per patient, 5%, OR 7.73, p = 0.007; per lesion, 2.4%, OR 6.31, p = 0.003). Conclusion: HB therapy is a major risk factor for PPB. Among patients without HB, anticoagulant + antiplatelet therapy was a significant risk factor for PPB.

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Postpolypectomy bleeding of colorectal polyps in patients with continuous warfarin and short-term interruption of direct oral anticoagulants

Harada

Miyaoka

Yuki

et al. 2021

Gastrointestinal Endoscopy

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Continuation of antithrombotic therapy may be associated with a high incidence of colonic post‐polypectomy bleeding

Abstract: The present study showed that the overall PPB rate under the new guidelines was not significantly higher when compared with the previous data obtained before the new guidelines were introduced.

Cited by 13 publications

References 32 publications

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Risk Analysis of Colorectal Post-Polypectomy Bleeding Due to Antithrombotic Agent

Postpolypectomy bleeding of colorectal polyps in patients with continuous warfarin and short-term interruption of direct oral anticoagulants

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