Why the study?
Increasing use of antiplatelet and antithrombotic agents alongside more complex endoscopic procedures requires clinicians to balance thromboembolic and bleeding risks.
A review discussing the management of antiplatelet and antithrombotic agents during endoscopic procedures, balancing thromboembolic and bleeding risks in the Indian context.
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Management decisions for antithrombotics during endoscopy remain individualized; leaves open optimal periprocedural strategies pending higher-level evidence.
The use of antiplatelet and antithrombotic agents has increased hand in hand with the number and complexity of endoscopic procedures. Hence, the endoscopists are often faced with considering endoscopy in patients on these agents. In this setting, to make informed decision, four key aspects are need to be considered. The type of antithrombotic or antiplatelet agent used and its characteristics, risk of thromboembolic events (which can lead to ischemic stroke or acute coronary syndrome, both of which carry high morbidity) due to withholding the drug, risk of bleeding (increases with invasiveness of procedure), and timing of procedure (elective or urgent) are the key factors to consider. We aim to discuss the risk of gastrointestinal bleed and endoscopic procedures on antiplatelet and antithrombotic agents focusing on Indian context based on recent Asia?pacific guidelines along with other existing guidelines.
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Pal et al. (2019) studied this question.
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