Hemothorax after chest tube insertion for pneumothorax as a complication of clopidogrel

Abstract

<jats:title>Abstract</jats:title><jats:p>Hemorrhagic complications are recognized when anti-platelet agents are used during or after surgical procedures. We present a 69-year-old male patient who developed hemothorax after chest tube insertion for pneumothorax as a complication of clopidogrel and aspirin following ischemic heart disease. Hemothorax associated clopidogrel has rarely been reported and this is the first academic publication of this complication type following chest tube insertion shortly after the cessation of clopidogrel. Our case demonstrates the possibility of hemothorax when chest tube insertion is indicated under such conditions.</jats:p>

Risk of bleeding in patients undergoing pulmonary procedures on antiplatelet or anticoagulants: A systematic review

“…Although 5 studies [26,29,[32][33][34] were identified evaluating bleeding risk in patients receiving clopidogrel undergoing small bore chest tube insertion, only 1 demonstrated level 2 grade evidence, and this study only included 8 patients [26]. In this study, no patient undergoing chest tube insertion experienced a bleeding complication.…”

“…The remaining articles were all case series and case reports and are summarized in Table 4. Although only 1 serious bleeding event is reported [34], due to the quality, sample size, and high risk of bias in these studies the grade of recommendation is D for safe performance of small bore chest tube in patients receiving clopidogrel. No studies evaluated risk of bleeding in patients on therapeutic anticoagulation.…”