Key result
Minimal DOAC interruption without heparin bridging proves safe for elective GI endoscopy.
Why the study?
Periprocedural management of DOAC-treated patients undergoing digestive endoscopy lacks consensus and requires synthesis of thromboembolic and bleeding risk data.
What is the optimal periprocedural management of DOACs in patients undergoing elective gastrointestinal endoscopy?
What is the optimal periprocedural management of DOACs in patients undergoing elective gastrointestinal endoscopy?
This review supports contemporary guidelines recommending minimal DOAC interruption without heparin bridging for patients undergoing elective GI endoscopy.
Answers are grounded in this paper and cite their sources.
Reinforces guideline-directed minimal DOAC interruption without bridging in elective GI endoscopy; leaves open need for prospective RCTs.
This narrative review summarizes the current body of literature regarding periprocedural management of direct oral anticoagulant (DOAC)-treated patients undergoing digestive endoscopy since the publication of the 2022 American College of Gastroenterology - Canadian Association of Gastroenterology guidelines. We provide a detailed analysis of the thromboembolic risk, endoscopic procedure-specific bleeding risks, contemporary intraprocedural techniques to reduce the bleeding risk, and a summary of periprocedural DOAC guidelines developed by major gastrointestinal societies, including recommendations on procedure risk stratification. Despite data heterogeneity, the overall trend of the current literature supports the contemporary practice of a minimal DOAC interruption without the need for heparin bridging.
No takes yet. Share an insight, caveat, or question.
Hansen-Barkun et al. (2024) conducted a review in Patients on direct oral anticoagulants undergoing elective gastrointestinal endoscopy. Minimal DOAC interruption without heparin bridging vs. Heparin bridging or extensive interruption was evaluated. Current literature supports the contemporary practice of minimal direct oral anticoagulant interruption without the need for heparin bridging in patients undergoing elective gastrointestinal endoscopy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: