Key result
Current guidelines recommend continuing antithrombotics before elective endoscopy and biopsy, though management of direct oral anticoagulants and high-risk procedures requires specific adjustments.
Why the study?
Although guidelines generally recommend continuing antithrombotics before elective endoscopy and biopsy, many endoscopists do not adhere to these recommendations, complicating management decisions.
How should antithrombotic agents be managed before endoscopy and biopsy according to current guidelines?
How should antithrombotic agents be managed before endoscopy and biopsy according to current guidelines?
Despite guideline recommendations to continue antithrombotics for low-risk endoscopic procedures to prevent cardiovascular complications, clinical practice often deviates due to concerns about post-endoscopic bleeding.
Guides endoscopists on balancing bleeding versus thrombotic risks with antithrombotics before procedures; extends prior guidance to include DOACs.
Antithrombotics are increasingly used for the management and prevention of cardiovascular diseases, and endoscopists often have to decide whether to continue or stop these medications before endoscopy. The development of novel antithrombotics, such as direct oral anticoagulants, has complicated their management before endoscopy. Although the discontinuation of anticoagulants may decrease the incidence of bleeding after endoscopic procedures, discontinuation may also lead to more serious cardiovascular complications. Although the majority of current practice guidelines recommend continuation of antithrombotics before elective endoscopy and biopsy, surveys have shown that many endoscopists do not adhere to these guidelines, probably due to legal aspirations from post endoscopic bleeding. Thus, we examined the current guidelines for the management of antithrombotics before endoscopy.
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Ahn et al. (2019) conducted a review in Patients on antithrombotics undergoing endoscopy. Antithrombotics (antiplatelets and anticoagulants) was evaluated. Current guidelines recommend continuing antithrombotics before elective endoscopy and biopsy, though management of direct oral anticoagulants and high-risk procedures requires specific adjustments.
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