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Management of antithrombotic agents and current issues in patients undergoing endoscopic submucosal dissection

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초록

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.

참고문헌 (43)

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Postoperative Bleeding Risk after Gastric Endoscopic Submucosal Dissection in Patients Receiving a P2Y12 Receptor AntagonistHamada Kenta, Hirai Ryosuke, Inoo Shoko, Iwamuro Masaya, Kanzaki Hiromitsu, Kawahara Yoshiro, Kawano Seiji, Kono Yoshiyasu, Kuraoka Sakiko, Okada Hiroyuki, Okanoue Shotaro, Satomi Takuya거트앤리버 소화기연관학회협의회 · Gut and Liver2023 · 제17권 제3호Continuous Use of Thienopyridine May Be as Safe as Low-Dose Aspirin in Endoscopic Resection of Gastric TumHyo-Joon Yang, Hyun Chae Jung, Hyunsoo Chung, Jae Yong Park, Ji Min Choi, Joo Hyun Lim, Jue Lie Kim, Jung Kim, Sang Gyun Kim, Seung Jun Han, Sooyeon Oh거트앤리버 소화기연관학회협의회 · Gut and Liver2018 · 제12권 제4호Is the Reinitiation of Antiplatelet Agents Safe at 1 Week after Gastric Endoscopic Submucosal Dissection? Assessment of Bleeding Risk Using the Forrest Classification김영일, 김찬규, 이종열, 조수정, 최일주거트앤리버 소화기연관학회협의회 · Gut and Liver2017 · 제11권 제4호International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopyChang Seok Bang, Cheol Min Shin, Christopher Khor, Chung Hyun Tae, Geun Am Song, Joo Ha Hwang, Kee Don Choi, Ki-Nam Shim, Miyoung Choi, Oh Young Lee, Philip Wai Yan Chiu, Rungsun Rerknimitr, Seung Joo Kang, Vu Van Khien, Young-Hoon Jeong, Yutaka Saito대한소화기내시경학회 · Clinical Endoscopy2024 · 제57권 제2호International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy송근암, 심기남, 태정현, Bang Chang Seok, Chiu Philip Wai Yan, Choi Kee Don, Choi Miyoung, Hwang Joo Ha, Jeong Young-Hoon, Kang Seung Joo, Khien Vu Van, Khor Christopher, Lee Oh Young, Rerknimitr Rungsun, Saito Yutaka, Shin Cheol Min거트앤리버 소화기연관학회협의회 · Gut and Liver2024 · 제18권 제5호Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy임현, 공은정, 김호각, 민병훈, 박찬국, 이수택, 조주영, Cheol Min Shin, Hoon Jai Chun, Jeong-Sik Byeon, Miyoung Choi, Seung Joo Kang대한소화기내시경학회 · Clinical Endoscopy2020 · 제53권 제6호

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