Anticoagulant and Antiplatelet Therapy in Periprocedural Period of Elective Gastrointestinal Endoscopy

Nikolay Tsonev; D. Vandeva; K. Toncheva; D. Zvezdov

doi:10.3889/oamjms.2022.8987

Authors

Nikolay Tsonev Clinic of Gastroenterology, Second MHAT Sofia, Sofia, Bulgaria
D. Vandeva Clinic of Gastroenterology, Second MHAT Sofia, Sofia, Bulgaria
K. Toncheva Clinic of Gastroenterology, Second MHAT Sofia, Sofia, Bulgaria
D. Zvezdov Clinic of Gastroenterology, Second MHAT Sofia, Sofia, Bulgaria

DOI:

https://doi.org/10.3889/oamjms.2022.8987

Keywords:

Anticoagulants, Antiplatelet agents, Gastrointestinal bleeding, Management

Abstract

Anticoagulants and antiplatelet agents are widely used drugs for cardiovascular prevention and reducing the risk of thromboembolic events. Gastrointestinal bleeding represents a serious complication of their use. Gastrointestinal endoscopy is related to bleeding risk – there is bleeding risk stratification according to endoscopic procedures (high- and low-risk ones). Treatment with antithrombotic drugs in the periprocedural endoscopic period is based on balancing the bleeding risk against the thromboembolic risk. Antithrombotic agents in endoscopic procedures with lower bleeding risk are not needed to be withheld. It is recommended temporary discontinuation of antithrombotic treatment in high-risk endoscopic procedures and to consider the use of “bridging” therapy with LWMH for patients on Vitamin K antagonists who are at high thrombotic risk. Evaluating cardiovascular risk and management of antithrombotic therapy could be a challenge for gastrointestinal endoscopists, therefore, collaboration with a cardiologist is of great importance, at least for some patients.

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