Year 2017 / Volume 109 / Number 1
Review
Endoscopic resection of colorectal polyps in patients on antiplatelet therapy: an evidence-based guidance for clinicians

49-59

DOI: 10.17235/reed.2016.4114/2015

Gema Plumé Gimeno, Marco Bustamante-Balén, Carla Satorres Paniagua, Francia Carolina Díaz Jaime, Maria José Cejalvo Andújar,

Abstract
Due to the rising prevalence of coronary heart disease, endoscopists are more frequently performing a polypectomy in patients on antiplatelet therapy (APT) and dual antiplatelet therapy (DATP). Despite the availability of several guidelines with regard to the management of antiplatelet drugs during the periprocedure period, there is still variability in the current clinical practice. This may be influenced by the low quality of the evidence supporting recommendations, because most of the studies dealing with APT and polypectomy are observational and retrospective, and include mainly small (< 10 mm) polyps. However, some recommendations can still be made. An estimation of the bleeding and thrombotic risk of the patient should be made in advance. In the case of DAPT the procedure should be postponed, at least until clopidogrel can be safely withheld. If possible, non-aspirin antiplatelet drugs should be withheld 5-7 days before the procedure. Polyp size is the main factor related with post-polypectomy bleeding and it is the factor that should drive clinical decisions regarding the resection method and the use of endoscopic prophylactic measures. Non-aspirin antiplatelet agents can be reintroduced 24-48 hours after the procedure. In conclusion, there is little data with regard to the management of DAPT in patients with a scheduled polypectomy. Large randomized controlled trials are needed to support clinical recommendations.
Share Button
New comment
Comments
No comments for this article
References
1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, 3rd, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, American Heart Association Statistics C, Stroke Statistics S (2014) Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 129 (3):e28-e292. doi:10.1161/01.cir.0000441139.02102.80
2. Kolh P, Windecker S, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Juni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A, Guidelines ESCCfP, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Committee ECG, Sousa Uva M, Achenbach S, Pepper J, Anyanwu A, Badimon L, Bauersachs J, Baumbach A, Beygui F, Bonaros N, De Carlo M, Deaton C, Dobrev D, Dunning J, Eeckhout E, Gielen S, Hasdai D, Kirchhof P, Luckraz H, Mahrholdt H, Montalescot G, Paparella D, Rastan AJ, Sanmartin M, Sergeant P, Silber S, Tamargo J, ten Berg J, Thiele H, van Geuns RJ, Wagner HO, Wassmann S, Wendler O, Zamorano JL (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 46 (4):517-592. doi:10.1093/ejcts/ezu366
3. Kleiman NS (2012) Grabbing the horns of a dilemma: the duration of dual antiplatelet therapy after stent implantation. Circulation 125 (16):1967-1970. doi:10.1161/CIRCULATIONAHA.112.102335
4. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, Caso P, Dudek D, Gielen S, Huber K, Ohman M, Petrie MC, Sonntag F, Uva MS, Storey RF, Wijns W, Zahger D, Guidelines ESCCfP (2011) ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European heart journal 32 (23):2999-3054. doi:10.1093/eurheartj/ehr236
5. Strul H, Kariv R, Leshno M, Halak A, Jakubowicz M, Santo M, Umansky M, Shirin H, Degani Y, Revivo M, Halpern Z, Arber N (2006) The prevalence rate and anatomic location of colorectal adenoma and cancer detected by colonoscopy in average-risk individuals aged 40-80 years. The American journal of gastroenterology 101 (2):255-262. doi:10.1111/j.1572-0241.2006.00430.x
6. Boustiere C, Veitch A, Vanbiervliet G, Bulois P, Deprez P, Laquiere A, Laugier R, Lesur G, Mosler P, Nalet B, Napoleon B, Rembacken B, Ajzenberg N, Collet JP, Baron T, Dumonceau JM, European Society of Gastrointestinal E (2011) Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 43 (5):445-461. doi:10.1055/s-0030-1256317
7. Committee ASoP, Anderson MA, Ben-Menachem T, Gan SI, Appalaneni V, Banerjee S, Cash BD, Fisher L, Harrison ME, Fanelli RD, Fukami N, Ikenberry SO, Jain R, Khan K, Krinsky ML, Lichtenstein DR, Maple JT, Shen B, Strohmeyer L, Baron T, Dominitz JA (2009) Management of antithrombotic agents for endoscopic procedures. Gastrointestinal endoscopy 70 (6):1060-1070. doi:10.1016/j.gie.2009.09.040
8. Fujimoto K, Fujishiro M, Kato M, Higuchi K, Iwakiri R, Sakamoto C, Uchiyama S, Kashiwagi A, Ogawa H, Murakami K, Mine T, Yoshino J, Kinoshita Y, Ichinose M, Matsui T, Japan Gastroenterological Endoscopy S (2014) Guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 26 (1):1-14. doi:10.1111/den.12183
9. Veitch AM, Baglin TP, Gershlick AH, Harnden SM, Tighe R, Cairns S, British Society of G, British Committee for Standards in H, British Cardiovascular Intervention S (2008) Guidelines for the management of anticoagulant and antiplatelet therapy in patients undergoing endoscopic procedures. Gut 57 (9):1322-1329. doi:10.1136/gut.2007.142497
10. Baron TH, Kamath PS, McBane RD (2013) Management of antithrombotic therapy in patients undergoing invasive procedures. The New England journal of medicine 368 (22):2113-2124. doi:10.1056/NEJMra1206531
11. Baron TH, Kamath PS, McBane RD (2014) New anticoagulant and antiplatelet agents: a primer for the gastroenterologist. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 12 (2):187-195. doi:10.1016/j.cgh.2013.05.020
12. Kanakadandi V, Parasa S, Sihn P, Singh M, Giacchino M, Gupta N, Gaddam S, Rastogi A, Bansal A, Petrini J, Sharma P (2015) Patterns of antiplatelet agent use in the US. Endosc Int Open 3 (3):E173-178. doi:10.1055/s-0034-1390750
13. Abdel Samie A, Theilmann L, Labenz J, Algk (2014) Endoscopic procedures in patients under clopidogrel or dual antiplatelet therapy: a survey among German gastroenterologists and current guidelines. Zeitschrift fur Gastroenterologie 52 (5):425-428. doi:10.1055/s-0033-1355862
14. Lee SY, Tang SJ, Rockey DC, Weinstein D, Lara L, Sreenarasimhaiah J, Choi KW, Korean Association for the Study of Intestinal D (2008) Managing anticoagulation and antiplatelet medications in GI endoscopy: a survey comparing the East and the West. Gastrointestinal endoscopy 67 (7):1076-1081. doi:10.1016/j.gie.2007.11.037
15. Carter D, Beer-Gabel M, Eliakim R, Novis B, Avidan B, Bardan E (2013) Management of antithrombotic agents for colonoscopic polypectomies in Israeli gastroenterologists relative to published guidelines. Clinics and research in hepatology and gastroenterology 37 (5):514-518. doi:10.1016/j.clinre.2013.03.010
16. Robbins R, Tian C, Singal A, Agrawal D (2015) Periprocedural management of aspirin during colonoscopy: a survey of practice patterns in the United States. Gastrointestinal endoscopy. doi:10.1016/j.gie.2015.03.1976
17. Alberca-de-Las-Parras F, Marin F, Roldan-Schilling V, Carballo-Alvarez F (2015) Management of antithrombotic drugs in association with endoscopic procedures. Rev Esp Enferm Dig 107 (5):289-306
18. Gonzalez Barcenas ML, Perez Aisa A (2016) Management of antiplatelet and anticoagulant therapy for endoscopic procedures: Introduction to novel oral anticoagulants. Rev Esp Enferm Dig 108 (2):89-96. doi:10.17235/reed.2016.3811/2015
19. Gresele P (2013) Antiplatelet agents in clinical practice and their haemorrhagic risk. Blood transfusion = Trasfusione del sangue 11 (3):349-356. doi:10.2450/2013.0248-12
20. Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V, Filippatos G, Fox K, Huber K, Kastrati A, Rosengren A, Steg PG, Tubaro M, Verheugt F, Weidinger F, Weis M, Guidelines ESCCfP (2008) Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. European heart journal 29 (23):2909-2945. doi:10.1093/eurheartj/ehn416
21. American College of Emergency P, Society for Cardiovascular A, Interventions, O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Jr., Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology 61 (4):e78-140. doi:10.1016/j.jacc.2012.11.019
22. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Jr., Ganiats TG, Holmes DR, Jr., Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ (2014) 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology 64 (24):2645-2687. doi:10.1016/j.jacc.2014.09.016
23. Eikelboom JW, Hirsh J, Spencer FA, Baglin TP, Weitz JI (2012) Antiplatelet drugs: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141 (2 Suppl):e89S-119S. doi:10.1378/chest.11-2293
24. Dobesh PP, Oestreich JH (2014) Ticagrelor: pharmacokinetics, pharmacodynamics, clinical efficacy, and safety. Pharmacotherapy 34 (10):1077-1090. doi:10.1002/phar.1477
25. Rutter MD, Nickerson C, Rees CJ, Patnick J, Blanks RG (2014) Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme. Endoscopy 46 (2):90-97. doi:10.1055/s-0033-1344987
26. Heldwein W, Dollhopf M, Rosch T, Meining A, Schmidtsdorff G, Hasford J, Hermanek P, Burlefinger R, Birkner B, Schmitt W, Munich Gastroenterology G (2005) The Munich Polypectomy Study (MUPS): prospective analysis of complications and risk factors in 4000 colonic snare polypectomies. Endoscopy 37 (11):1116-1122. doi:10.1055/s-2005-870512
27. Kim HS, Kim TI, Kim WH, Kim YH, Kim HJ, Yang SK, Myung SJ, Byeon JS, Lee MS, Chung IK, Jung SA, Jeen YT, Choi JH, Choi KY, Choi H, Han DS, Song JS (2006) Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. The American journal of gastroenterology 101 (6):1333-1341. doi:10.1111/j.1572-0241.2006.00638.x
28. Choung BS, Kim SH, Ahn DS, Kwon DH, Koh KH, Sohn JY, Park WS, Kim IH, Lee SO, Lee ST, Kim SW (2014) Incidence and risk factors of delayed postpolypectomy bleeding: a retrospective cohort study. Journal of clinical gastroenterology 48 (9):784-789. doi:10.1097/MCG.0000000000000027
29. Gimeno-Garcia AZ, de Ganzo ZA, Sosa AJ, Perez DN, Quintero E (2012) Incidence and predictors of postpolypectomy bleeding in colorectal polyps larger than 10 mm. Eur J Gastroenterol Hepatol 24 (5):520-526. doi:10.1097/MEG.0b013e328350fcdc
30. Zhang Q, An S, Chen Z, Fu FH, Jiang B, Zhi F, Bai Y, Gong W (2014) Assessment of risk factors for delayed colonic post-polypectomy hemorrhage: a study of 15553 polypectomies from 2005 to 2013. PloS one 9 (10):e108290. doi:10.1371/journal.pone.0108290
31. Sawhney MS, Salfiti N, Nelson DB, Lederle FA, Bond JH (2008) Risk factors for severe delayed postpolypectomy bleeding. Endoscopy 40 (2):115-119. doi:10.1055/s-2007-966959
32. Hassan C, Repici A, Sharma P, Correale L, Zullo A, Bretthauer M, Senore C, Spada C, Bellisario C, Bhandari P, Rex DK (2015) Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut. doi:10.1136/gutjnl-2014-308481
33. Albéniz EF, M.; Martinez-Ares, D.; Pin, N.; Alonso, P.; Leon-Brito, H.; Guarner-Argente, C.; Gargallo, C.J.; Ramos, F.; Pellise, M.; Soto, S.; Remedios-Espino, D.; Rodriguez-Sanchez, J.; Lopez-Viedma, B.; Mugica, F.; Cobian, J.; Nogales, O.; Redondo E; Rodriguez-Tellez M; Jimenez-García, V.A.; Herreros de Tejada, A.; Santiago, J.; Pardeiro, M.R.; Alvarez, M.A.; de la Peña, J.; Lopez-Roses, L.; Martinez-Alcala, F.; Garcia, O.; Zuñiga, A.; Ono, A.; Perez-Roldan, F.; Jimenez-Perez, J. (2015) Considerations from the first delayed bleeding risk score for endoscopic mucosal resection of large colorectal lesions: to clip or not to clip? United European gastroenterology journal 3 (5 (Suppl. 1)). doi:10.1177/2050640615601611
34. Wada Y, Kudo SE, Tanaka S, Saito Y, Iishii H, Ikematsu H, Igarashi M, Saitoh Y, Inoue Y, Kobayashi K, Hisabe T, Tsuruta O, Kashida H, Ishikawa H, Sugihara K (2015) Predictive factors for complications in endoscopic resection of large colorectal lesions: a multicenter prospective study. Surgical endoscopy 29 (5):1216-1222. doi:10.1007/s00464-014-3799-9
35. Wu XR, Church JM, Jarrar A, Liang J, Kalady MF (2013) Risk factors for delayed postpolypectomy bleeding: how to minimize your patients' risk. International journal of colorectal disease 28 (8):1127-1134. doi:10.1007/s00384-013-1661-5
36. Watabe H, Yamaji Y, Okamoto M, Kondo S, Ohta M, Ikenoue T, Kato J, Togo G, Matsumura M, Yoshida H, Kawabe T, Omata M (2006) Risk assessment for delayed hemorrhagic complication of colonic polypectomy: polyp-related factors and patient-related factors. Gastrointestinal endoscopy 64 (1):73-78. doi:10.1016/j.gie.2006.02.054
37. Jeon JW, Shin HP, Lee JI, Joo KR, Pack KM, Cha JM, Park JJ, Lim JU, Lim K (2012) The risk of postpolypectomy bleeding during colonoscopy in patients with early liver cirrhosis. Surgical endoscopy 26 (11):3258-3263. doi:10.1007/s00464-012-2334-0
38. Burgess NG, Metz AJ, Williams SJ, Singh R, Tam W, Hourigan LF, Zanati SA, Brown GJ, Sonson R, Bourke MJ (2014) Risk factors for intraprocedural and clinically significant delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 12 (4):651-661 e651-653. doi:10.1016/j.cgh.2013.09.049
39. Rabeneck L, Paszat LF, Hilsden RJ, Saskin R, Leddin D, Grunfeld E, Wai E, Goldwasser M, Sutradhar R, Stukel TA (2008) Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology 135 (6):1899-1906, 1906 e1891. doi:10.1053/j.gastro.2008.08.058
40. Heresbach D, Kornhauser R, Seyrig JA, Coumaros D, Claviere C, Bury A, Cottereau J, Canard JM, Chaussade S, Baudet A, Casteur A, Duval O, Ponchon T, group O (2010) A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia. Endoscopy 42 (10):806-813. doi:10.1055/s-0030-1255715
41. Repici A, Hassan C, De Paula Pessoa D, Pagano N, Arezzo A, Zullo A, Lorenzetti R, Marmo R (2012) Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 44 (2):137-150. doi:10.1055/s-0031-1291448
42. Rahmi G, Hotayt B, Chaussade S, Lepilliez V, Giovannini M, Coumaros D, Charachon A, Cholet F, Laquiere A, Samaha E, Prat F, Ponchon T, Bories E, Robaszkiewicz M, Boustiere C, Cellier C (2014) Endoscopic submucosal dissection for superficial rectal tumors: prospective evaluation in France. Endoscopy 46 (8):670-676. doi:10.1055/s-0034-1365810
43. Terasaki M, Tanaka S, Shigita K, Asayama N, Nishiyama S, Hayashi N, Nakadoi K, Oka S, Chayama K (2014) Risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal neoplasms. International journal of colorectal disease 29 (7):877-882. doi:10.1007/s00384-014-1901-3
44. Suzuki S, Chino A, Kishihara T, Uragami N, Tamegai Y, Suganuma T, Fujisaki J, Matsuura M, Itoi T, Gotoda T, Igarashi M, Moriyasu F (2014) Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms. World journal of gastroenterology : WJG 20 (7):1839-1845. doi:10.3748/wjg.v20.i7.1839
45. Hui AJ, Wong RM, Ching JY, Hung LC, Chung SC, Sung JJ (2004) Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointestinal endoscopy 59 (1):44-48
46. Shiffman ML, Farrel MT, Yee YS (1994) Risk of bleeding after endoscopic biopsy or polypectomy in patients taking aspirin or other NSAIDS. Gastrointestinal endoscopy 40 (4):458-462
47. Yousfi M, Gostout CJ, Baron TH, Hernandez JL, Keate R, Fleischer DE, Sorbi D (2004) Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. The American journal of gastroenterology 99 (9):1785-1789. doi:10.1111/j.1572-0241.2004.30368.x
48. Manocha D, Singh M, Mehta N, Murthy UK (2012) Bleeding risk after invasive procedures in aspirin/NSAID users: polypectomy study in veterans. The American journal of medicine 125 (12):1222-1227. doi:10.1016/j.amjmed.2012.05.030
49. Friedland S (2009) Colonoscopy with polypectomy in patients taking clopidogrel. Gastroenterology Research 2 (4):4. doi:10.4021/gr2009.08.1308
50. Singh M, Mehta N, Murthy UK, Kaul V, Arif A, Newman N (2010) Postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel therapy. Gastrointestinal endoscopy 71 (6):998-1005. doi:10.1016/j.gie.2009.11.022
51. Feagins LA, Uddin FS, Davila RE, Harford WV, Spechler SJ (2011) The rate of post-polypectomy bleeding for patients on uninterrupted clopidogrel therapy during elective colonoscopy is acceptably low. Digestive diseases and sciences 56 (9):2631-2638. doi:10.1007/s10620-011-1682-2
52. Feagins LA, Iqbal R, Harford WV, Halai A, Cryer BL, Dunbar KB, Davila RE, Spechler SJ (2013) Low rate of postpolypectomy bleeding among patients who continue thienopyridine therapy during colonoscopy. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 11 (10):1325-1332. doi:10.1016/j.cgh.2013.02.003
53. Grossman E, Maranino, A., Zamora, D., DiMaio, C., Denton, B., Gönen, M., Ludwig, E., Markovitz, A., Schattner, M., Shike, M., Kurtz, R., Winawer, S., Gerdes, H. (2010) Antiplatelet medications increase the risk of post-polypectomy bleeding. The American journal of gastroenterology 105 (Suppl. 1):S391-392. doi:10.1038/ajg.2010.320_8
54. Rodino S, Sebkova L, D'Amico T, Sacca N (2012) Sa1146 Colon Polypectomy in Patients During Clopidogrel Therapy: an Acceptable Risk. Gastroenterology 142 (5):S-228. doi:10.1016/S0016-5085(12)60853-1
55. Gandhi S, Narula N, Mosleh W, Marshall JK, Farkouh M (2013) Meta-analysis: colonoscopic post-polypectomy bleeding in patients on continued clopidogrel therapy. Alimentary pharmacology & therapeutics 37 (10):947-952. doi:10.1111/apt.12292
56. Shalman D, Gerson LB (2015) Systematic review with meta-analysis: the risk of gastrointestinal haemorrhage post-polypectomy in patients receiving anti-platelet, anti-coagulant and/or thienopyridine medications. Alimentary pharmacology & therapeutics 42 (8):949-956. doi:10.1111/apt.13367
57. Bahin FF, Naidoo M, Williams SJ, Hourigan LF, Ormonde DG, Raftopoulos SC, Holt BA, Sonson R, Bourke MJ (2015) Prophylactic endoscopic coagulation to prevent bleeding after wide-field endoscopic mucosal resection of large sessile colon polyps. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 13 (4):724-730 e722. doi:10.1016/j.cgh.2014.07.063
58. Metz AJ, Bourke MJ, Moss A, Williams SJ, Swan MP, Byth K (2011) Factors that predict bleeding following endoscopic mucosal resection of large colonic lesions. Endoscopy 43 (6):506-511. doi:10.1055/s-0030-1256346
59. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH, American College of Cardiology F, American Heart Association Task Force on Practice G, Society for Cardiovascular A, Interventions (2011) 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Journal of the American College of Cardiology 58 (24):e44-122. doi:10.1016/j.jacc.2011.08.007
60. Iakovou I, Schmidt T, Bonizzoni E, Ge L, Sangiorgi GM, Stankovic G, Airoldi F, Chieffo A, Montorfano M, Carlino M, Michev I, Corvaja N, Briguori C, Gerckens U, Grube E, Colombo A (2005) Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. Jama 293 (17):2126-2130. doi:10.1001/jama.293.17.2126
61. Finn AV, Joner M, Nakazawa G, Kolodgie F, Newell J, John MC, Gold HK, Virmani R (2007) Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 115 (18):2435-2441. doi:10.1161/CIRCULATIONAHA.107.693739
62. Valgimigli M, Campo G, Monti M, Vranckx P, Percoco G, Tumscitz C, Castriota F, Colombo F, Tebaldi M, Fuca G, Kubbajeh M, Cangiano E, Minarelli M, Scalone A, Cavazza C, Frangione A, Borghesi M, Marchesini J, Parrinello G, Ferrari R, Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study I (2012) Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial. Circulation 125 (16):2015-2026. doi:10.1161/CIRCULATIONAHA.111.071589
63. Navarese EP, Andreotti F, Schulze V, Kolodziejczak M, Buffon A, Brouwer M, Costa F, Kowalewski M, Parati G, Lip GY, Kelm M, Valgimigli M (2015) Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: meta-analysis of randomised controlled trials. BMJ 350:h1618. doi:10.1136/bmj.h1618
64. Mauri L, Kereiakes DJ, Yeh RW, Driscoll-Shempp P, Cutlip DE, Steg PG, Normand SL, Braunwald E, Wiviott SD, Cohen DJ, Holmes DR, Jr., Krucoff MW, Hermiller J, Dauerman HL, Simon DI, Kandzari DE, Garratt KN, Lee DP, Pow TK, Ver Lee P, Rinaldi MJ, Massaro JM, Investigators DS (2014) Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. The New England journal of medicine 371 (23):2155-2166. doi:10.1056/NEJMoa1409312
65. Giustino G, Baber U, Sartori S, Mehran R, Mastoris I, Kini AS, Sharma SK, Pocock SJ, Dangas GD (2015) Duration of Dual Antiplatelet Therapy Following Drug-Eluting Stent Implantation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of the American College of Cardiology. doi:10.1016/j.jacc.2015.01.039
66. Cassese S, Byrne RA, Ndrepepa G, Schunkert H, Fusaro M, Kastrati A (2015) Prolonged dual antiplatelet therapy after drug-eluting stenting: meta-analysis of randomized trials. Clin Res Cardiol. doi:10.1007/s00392-015-0860-1
67. Mehran R, Baber U, Steg PG, Ariti C, Weisz G, Witzenbichler B, Henry TD, Kini AS, Stuckey T, Cohen DJ, Berger PB, Iakovou I, Dangas G, Waksman R, Antoniucci D, Sartori S, Krucoff MW, Hermiller JB, Shawl F, Gibson CM, Chieffo A, Alu M, Moliterno DJ, Colombo A, Pocock S (2013) Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet 382 (9906):1714-1722. doi:10.1016/S0140-6736(13)61720-1
68. Eisenberg MJ, Richard PR, Libersan D, Filion KB (2009) Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents. Circulation 119 (12):1634-1642. doi:10.1161/CIRCULATIONAHA.108.813667
69. Van Gossum A, Cozzoli A, Adler M, Taton G, Cremer M (1992) Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current. Gastrointestinal endoscopy 38 (4):472-475
70. Kim JS, Lee BI, Choi H, Jun SY, Park ES, Park JM, Lee IS, Kim BW, Kim SW, Choi MG (2015) Cold snare polypectomy versus cold forceps polypectomy for diminutive and small colorectal polyps: a randomized controlled trial. Gastrointestinal endoscopy 81 (3):741-747. doi:10.1016/j.gie.2014.11.048
71. Singh N, Harrison M, Rex DK (2004) A survey of colonoscopic polypectomy practices among clinical gastroenterologists. Gastrointestinal endoscopy 60 (3):414-418
72. Dobrowolski S, Dobosz M, Babicki A, Dymecki D, Hac S (2004) Prophylactic submucosal saline-adrenaline injection in colonoscopic polypectomy: prospective randomized study. Surgical endoscopy 18 (6):990-993. doi:10.1007/s00464-003-9214-6
73. Lee SH, Chung IK, Kim SJ, Kim JO, Ko BM, Kim WH, Kim HS, Park DI, Kim HJ, Byeon JS, Yang SK, Jang BI, Jung SA, Jeen YT, Choi JH, Choi H, Han DS, Song JS (2007) Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy: a prospective randomized, multicenter study. World journal of gastroenterology : WJG 13 (21):2973-2977
74. Hsieh YH, Lin HJ, Tseng GY, Perng CL, Li AF, Chang FY, Lee SD (2001) Is submucosal epinephrine injection necessary before polypectomy? A prospective, comparative study. Hepato-gastroenterology 48 (41):1379-1382
75. Shioji K, Suzuki Y, Kobayashi M, Nakamura A, Azumaya M, Takeuchi M, Baba Y, Honma T, Narisawa R (2003) Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy. Gastrointestinal endoscopy 57 (6):691-694. doi:10.1067/mge.2003.193
76. Quintanilla E, Castro JL, Rabago LR, Chico I, Olivares A, Ortega A, Vicente C, Carbo J, Gea F (2012) Is the use of prophylactic hemoclips in the endoscopic resection of large pedunculated polyps useful? A prospective and randomized study. Journal of interventional gastroenterology 2 (4):183-188. doi:10.4161/jig.23741
77. Zhang QS, Han B, Xu JH, Gao P, Shen YC (2015) Clip closure of defect after endoscopic resection in patients with larger colorectal tumors decreased the adverse events. Gastrointestinal endoscopy. doi:10.1016/j.gie.2015.04.005
78. Liaquat H, Rohn E, Rex DK (2013) Prophylactic clip closure reduced the risk of delayed postpolypectomy hemorrhage: experience in 277 clipped large sessile or flat colorectal lesions and 247 control lesions. Gastrointestinal endoscopy 77 (3):401-407. doi:10.1016/j.gie.2012.10.024
79. Feagins LA, Nguyen AD, Iqbal R, Spechler SJ (2014) The prophylactic placement of hemoclips to prevent delayed post-polypectomy bleeding: an unnecessary practice? A case control study. Digestive diseases and sciences 59 (4):823-828. doi:10.1007/s10620-014-3055-0
80. Parikh ND, Zanocco K, Keswani RN, Gawron AJ (2013) A cost-efficacy decision analysis of prophylactic clip placement after endoscopic removal of large polyps. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 11 (10):1319-1324. doi:10.1016/j.cgh.2012.12.044
81. Di Giorgio P, De Luca L, Calcagno G, Rivellini G, Mandato M, De Luca B (2004) Detachable snare versus epinephrine injection in the prevention of postpolypectomy bleeding: a randomized and controlled study. Endoscopy 36 (10):860-863. doi:10.1055/s-2004-825801
82. Ji JS, Lee SW, Kim TH, Cho YS, Kim HK, Lee KM, Kim SW, Choi H (2014) Comparison of prophylactic clip and endoloop application for the prevention of postpolypectomy bleeding in pedunculated colonic polyps: a prospective, randomized, multicenter study. Endoscopy 46 (7):598-604. doi:10.1055/s-0034-1365515
83. Li LY, Liu QS, Li L, Cao YJ, Yuan Q, Liang SW, Qu CM (2011) A meta-analysis and systematic review of prophylactic endoscopic treatments for postpolypectomy bleeding. International journal of colorectal disease 26 (6):709-719. doi:10.1007/s00384-011-1141-8
84. Corte CJ, Burger DC, Horgan G, Bailey AA, East JE (2014) Postpolypectomy haemorrhage following removal of large polyps using mechanical haemostasis or epinephrine: a meta-analysis. United European gastroenterology journal 2 (2):123-130. doi:10.1177/2050640614522619
85. Sung JY, Chung SC, Low JM, Cocks R, Ip SM, Tan P, Leung JW, Li AK, Oh TE (1993) Systemic absorption of epinephrine after endoscopic submucosal injection in patients with bleeding peptic ulcers. Gastrointestinal endoscopy 39 (1):20-22
86. Fahrtash-Bahin F, Holt BA, Jayasekeran V, Williams SJ, Sonson R, Bourke MJ (2013) Snare tip soft coagulation achieves effective and safe endoscopic hemostasis during wide-field endoscopic resection of large colonic lesions (with videos). Gastrointestinal endoscopy 78 (1):158-163 e151. doi:10.1016/j.gie.2013.02.030
87. Becker RC, Scheiman J, Dauerman HL, Spencer F, Rao S, Sabatine M, Johnson DA, Chan F, Abraham NS, Quigley EM, American College of C, the American College of G (2009) Management of platelet-directed pharmacotherapy in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal procedures. The American journal of gastroenterology 104 (12):2903-2917. doi:10.1038/ajg.2009.667
88. Sung JJ, Lau JY, Ching JY, Wu JC, Lee YT, Chiu PW, Leung VK, Wong VW, Chan FK (2010) Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med 152 (1):1-9. doi:10.7326/0003-4819-152-1-201001050-00179
Related articles

Digestive Diseases Image

Underwater polypectomy at the appendiceal orifice in a patient on anticoagulation

DOI: 10.17235/reed.2023.9842/2023

Letter

An uncommon colonic polyp

DOI: 10.17235/reed.2022.9160/2022

Digestive Diseases Image

Intestinal obstruction due to bariolith impaction

DOI: 10.17235/reed.2022.9084/2022

Letter

Anorectal malignant melanoma, a diagnostic challenge

DOI: 10.17235/reed.2022.9068/2022

Letter

Lead ingestion, medical emergency and action plan

DOI: 10.17235/reed.2022.9048/2022

Letter

Endoscopic findings of radiation ileitis

DOI: 10.17235/reed.2022.9036/2022

Letter

Endoscopic imaging of pneumatosis intestinalis

DOI: 10.17235/reed.2022.8972/2022

Editorial

Colonoscopy — When quality matters

DOI: 10.17235/reed.2022.8942/2022

Digestive Diseases Image

Colonic Kaposi’s sarcoma as the first clinical manifestation of undiagnosed HIV

DOI: 10.17235/reed.2022.8717/2022

Letter

A rare gastrointestinal tumor: primary gastric melanoma

DOI: 10.17235/reed.2022.8715/2022

Letter

Gastrointestinal lymphoma, a rare endoscopic lesion

DOI: 10.17235/reed.2022.8555/2021

Letter

Cecal MALT lymphoma: a challenging diagnosis

DOI: 10.17235/reed.2021.8526/2021

Digestive Diseases Image

Cold loop polypectomy perforation of a tiny colon polyp

DOI: 10.17235/reed.2021.8221/2021

Letter

Surprises in cecal intubation: foreign bodies in the colon

DOI: 10.17235/reed.2021.8155/2021

Letter

Bochdalek hernia: use of capsule endoscopy

DOI: 10.17235/reed.2021.7760/2020

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Letter

Colonic adenocarcinoma arising from traditional serrated adenoma

DOI: 10.17235/reed.2020.6818/2019

Letter

Gastric ulcer due to mucormycosis in a critical patient

DOI: 10.17235/reed.2020.6636/2019

Case Report

Primary colon mantle lymphoma: a misleading macroscopic appearance!

DOI: 10.17235/reed.2019.6405/2019

Digestive Diseases Image

Colorectal penetration by two intrauterine devices

DOI: 10.17235/reed.2019.5974/2018

Letter

A granular cell tumor: an unusual colon polyp

DOI: 10.17235/reed.2018.5918/2018

Editorial

Colorectal cancer screening and survival

DOI: 10.17235/reed.2018.5870/2018

Letter

Bacterial endogenous endophthalmitis after colonoscopy

DOI: 10.17235/reed.2018.5658/2018

Review

Quality indicators in colonoscopy. The colonoscopy procedure

DOI: 10.17235/reed.2018.5408/2017

Letter to the Editor

A rare complication after colonoscopy: a splenic rupture

DOI: 10.17235/reed.2018.5362/2017

Letter to the Editor

Acute appendicitis after a colonic endoscopic submucosal resection

DOI: 10.17235/reed.2018.5307/2017

Digestive Diseases Image

Contribution of the virtual colonoscopy in a case of intestinal intussusception

DOI: 10.17235/reed.2017.5261/2017

Digestive Diseases Image

A bull horn fragment found on colonoscopy

DOI: 10.17235/reed.2017.5020/2017

Editorial

Issue pending: minimizing anxiety before colonoscopy

DOI: 10.17235/reed.2016.4756/2016

Digestive Diseases Image

Intrauterine device in the rectal cavity

Letter to the Editor

Primary chancre in the rectum: an underdiagnosed cause of rectal ulcer

DOI: 10.17235/reed.2017.4457/2016

Digestive Diseases Image

Pneumatosis cystoides intestinalis

Review

Serrated lesions and serrated polyposis syndrome

DOI: 10.17235/reed.2017.4065/2015

Case Report

Appendicular bleeding: an excepcional cause of lower hemorrhage

DOI: 10.17235/reed.2015.3828/2015

Letter to the Editor

Splenic rupture after colorectal cancer screening

DOI: 10.17235/reed.2015.3714/2015

Citation tools
Plumé Gimeno G, Bustamante-Balén M, Satorres Paniagua C, Díaz Jaime F, Cejalvo Andújar M. Endoscopic resection of colorectal polyps in patients on antiplatelet therapy: an evidence-based guidance for clinicians. 4114/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1976 visits.
This article has been downloaded 304 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 18/11/2015

Accepted: 14/05/2016

Online First: 04/11/2016

Published: 03/01/2017

Article revision time: 175 days

Article Online First time: 352 days

Article editing time: 412 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology