Management of antithrombotic agents and current issues in patients undergoing endoscopic submucosal dissection
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Postoperative bleeding is a common adverse event in endoscopic submucosal dissection (ESD) and may be life-threatening. Postoperative bleeding occurs frequently in patients treated with antithrombotic agents, including aspirin, antiplatelet agents, warfarin, and non-vitamin K-dependent oral anticoagulants. Due to the aging population and the increase in the risk of thromboembolic disease, the number of patients who require antithrom-botic therapy has increased. To date, several clinical studies have been conducted and several global guidelines have been updated. Nevertheless, de-termining the optimal use of antithrombotic agents in patients undergoing ESD is still challenging, and recommendations for the use of these agents vary slightly across different guidelines. In this review, I summarized the current guidelines and discussed several ongoing issues with the manage-ment of antithrombotic agents in patients undergoing ESD.
Abstract
Postoperative bleeding is a common adverse event in endoscopic submucosal dissection (ESD) and may be life-threatening. Postoperative bleeding occurs frequently in patients treated with antithrombotic agents, including aspirin, antiplatelet agents, warfarin, and non-vitamin K-dependent oral anticoagulants. Due to the aging population and the increase in the risk of thromboembolic disease, the number of patients who require antithrom-botic therapy has increased. To date, several clinical studies have been conducted and several global guidelines have been updated. Nevertheless, de-termining the optimal use of antithrombotic agents in patients undergoing ESD is still challenging, and recommendations for the use of these agents vary slightly across different guidelines. In this review, I summarized the current guidelines and discussed several ongoing issues with the manage-ment of antithrombotic agents in patients undergoing ESD.
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