Outcomes of Endoscopic Ultrasound-Guided Biliary Drainage in Patients Undergoing Antithrombotic Therapy
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Background/Aims: The Japan Gastroenterological Endoscopy Society (JGES) has published guidelines for gastroenterologicalendoscopy in patients undergoing antithrombotic treatment. These guidelines classify endoscopic ultrasound-guided biliary drainage(EUS-BD) as a high-risk procedure. Nevertheless, the bleeding risk of EUS-BD in patients undergoing antithrombotic therapy isuncertain. Therefore, this study aimed to assess the bleeding risk in patients undergoing antithrombotic therapy. Methods: This single-center retrospective study included 220 consecutive patients who underwent EUS-BD between January 2013and December 2018. We managed the withdrawal and continuation of antithrombotic agents according to the JGES guidelines. Wecompared the bleeding event rates among patients who received and those who did not receive antithrombotic agents. Results: A total of 18 patients (8.1 %) received antithrombotic agents and 202 patients (91.8 %) did not. Three patients experiencedbleeding events, with an overall bleeding event rate of 1.3% (3/220): one patient was in the antithrombotic group (5.5%) and twopatients were in the non-antithrombotic group (0.9%) (p=0.10). All cases were moderate. The sole thromboembolic event (0.4%) wasa cerebral infarction in a patient in the non-antithrombotic group. Conclusions: The rate of EUS-BD-related bleeding events was low. Even in patients receiving antithrombotic therapy, the bleedingevent rates were not significantly different from those in patients not receiving antithrombotic therapy.
Abstract
Background/Aims: The Japan Gastroenterological Endoscopy Society (JGES) has published guidelines for gastroenterologicalendoscopy in patients undergoing antithrombotic treatment. These guidelines classify endoscopic ultrasound-guided biliary drainage(EUS-BD) as a high-risk procedure. Nevertheless, the bleeding risk of EUS-BD in patients undergoing antithrombotic therapy isuncertain. Therefore, this study aimed to assess the bleeding risk in patients undergoing antithrombotic therapy. Methods: This single-center retrospective study included 220 consecutive patients who underwent EUS-BD between January 2013and December 2018. We managed the withdrawal and continuation of antithrombotic agents according to the JGES guidelines. Wecompared the bleeding event rates among patients who received and those who did not receive antithrombotic agents. Results: A total of 18 patients (8.1 %) received antithrombotic agents and 202 patients (91.8 %) did not. Three patients experiencedbleeding events, with an overall bleeding event rate of 1.3% (3/220): one patient was in the antithrombotic group (5.5%) and twopatients were in the non-antithrombotic group (0.9%) (p=0.10). All cases were moderate. The sole thromboembolic event (0.4%) wasa cerebral infarction in a patient in the non-antithrombotic group. Conclusions: The rate of EUS-BD-related bleeding events was low. Even in patients receiving antithrombotic therapy, the bleedingevent rates were not significantly different from those in patients not receiving antithrombotic therapy.
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