Abstract
Background: The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated. Aims: To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users. Methods: From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated. Results: A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases. Conclusions: Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.
| Original language | English |
|---|---|
| Pages (from-to) | 730-738 |
| Number of pages | 9 |
| Journal | Digestive Diseases and Sciences |
| Volume | 62 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2017 |
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Keywords
- Antithrombotic drug
- Endoscopy
- Guidelines
- Hemorrhage
- Thromboembolism
ASJC Scopus subject areas
- Physiology
- Gastroenterology
Cite this
Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users. / Kono, Yoshiyasu; Matsubara, Minoru; Toyokawa, Tatsuya; Takenaka, Ryuta; Suzuki, Seiyu; Nasu, Junichirou; Yoshioka, Masao; Nakagawa, Masahiro; Mizuno, Motowo; Sakae, Hiroyuki; Abe, Makoto; Gotoda, Tatsuhiro; Miura, Ko; Kanzaki, Hiromitsu; Iwamuro, Masaya; Hori, Keisuke; Tsuzuki, Takao; Kita, Masahide; Kawano, Seiji; Kawahara, Yoshiro; Okada, Hiroyuki.
In: Digestive Diseases and Sciences, Vol. 62, No. 3, 01.03.2017, p. 730-738.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users
AU - Kono, Yoshiyasu
AU - Matsubara, Minoru
AU - Toyokawa, Tatsuya
AU - Takenaka, Ryuta
AU - Suzuki, Seiyu
AU - Nasu, Junichirou
AU - Yoshioka, Masao
AU - Nakagawa, Masahiro
AU - Mizuno, Motowo
AU - Sakae, Hiroyuki
AU - Abe, Makoto
AU - Gotoda, Tatsuhiro
AU - Miura, Ko
AU - Kanzaki, Hiromitsu
AU - Iwamuro, Masaya
AU - Hori, Keisuke
AU - Tsuzuki, Takao
AU - Kita, Masahide
AU - Kawano, Seiji
AU - Kawahara, Yoshiro
AU - Okada, Hiroyuki
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated. Aims: To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users. Methods: From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated. Results: A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases. Conclusions: Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.
AB - Background: The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated. Aims: To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users. Methods: From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated. Results: A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases. Conclusions: Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.
KW - Antithrombotic drug
KW - Endoscopy
KW - Guidelines
KW - Hemorrhage
KW - Thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85008222801&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008222801&partnerID=8YFLogxK
U2 - 10.1007/s10620-016-4437-2
DO - 10.1007/s10620-016-4437-2
M3 - Article
VL - 62
SP - 730
EP - 738
JO - American Journal of Digestive Diseases
JF - American Journal of Digestive Diseases
SN - 0002-9211
IS - 3
ER -