Antiplatelets, anticoagulants, and colonoscopic polypectomy

Neena S Abraham
Gastrointestinal Endoscopy 2019 October 1
The management of antiplatelet and anticoagulant (ie, antithrombotic) agents is challenging in the peri-endoscopic setting. In this state-of-the-art update, we review current best practice recommendations focusing on the risk of immediate and delayed post-polypectomy bleeding (PPB) in the context of drug discontinuation (ie, temporary interruption) and drug continuation. The data regarding polypectomy technique (cold snare versus conventional thermal-based) and prophylactic placement of hemostatic clips are evaluated to assess if these endoscopic techniques are beneficial in reducing PPB. Finally, clinical takeaways are provided to facilitate safer polypectomy among patients on antiplatelet and anticoagulant agents.


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