Az antikoaguláns és thrombocytaaggregáció- gátló kezelés és az emésztorendszeri endoszkópia

Translated title of the contribution: Anticoagulation and antiplatelet therapy, and gastrointestinal endoscopy

Hajnal Székely, Zsolt Tulassay

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Over the past decade, the application of anticoagulant and antiplatelet agents for various cardiovascular and hematologic conditions has become more widespread. These medications can decrease the risk of thromboembolic events, meanwhile may potentiate gastrointestinal bleeding. The decision to reverse anticoagulation, thereby risking thromboembolic complications, must be carefully weighted against the increased risk of bleeding when maintaining anticoagulation. Elective procedures should be delayed in patients on temporary anticoagulation therapy (e.g. those with deep vein thrombosis). For procedures considered to have a low risk of bleeding (e.g. diagnostic endoscopy and biopsy) there is no need to discontinue or adjust anticoagulation. For procedures with a higher risk of bleeding (e.g. polypectomy and biliary sphincterotomy), an individual approach is required. This approach might include stopping oral anticoagulant therapy with or without the administration of unfractionated heparin or low-molecular-weight heparin for the preprocedure and postprocedure periods, during which the patient's international normalized ratio is in the subtherapeutic range. Antiplatelet drugs (aspirin, clopidogrel, ticlopidine) may also increase the risk of bleeding induced by gastrointestinal endoscopic procedures. There is no indication to stop the therapy before esophagogastroduodenoscopy. Discontinuation of aspirin 4-7 days (according to the cardiovascular risk) before other endoscopic procedures is recommended. When aspirin is indicated for primary prevention, it can be resumed 14 days and 10 days after polypectomy and sphincterotomy, respectively. In cases of secondary prevention, it should be resumed after 1 week.

Original languageHungarian
Pages (from-to)541-548
Number of pages8
JournalOrvosi Hetilap
Volume150
Issue number12
DOIs
Publication statusPublished - Mar 1 2009

Fingerprint

Gastrointestinal Endoscopy
Hemorrhage
Aspirin
clopidogrel
Platelet Aggregation Inhibitors
Anticoagulants
Therapeutics
Digestive System Endoscopy
Ticlopidine
International Normalized Ratio
Low Molecular Weight Heparin
Primary Prevention
Secondary Prevention
Venous Thrombosis
Endoscopy
Heparin
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Az antikoaguláns és thrombocytaaggregáció- gátló kezelés és az emésztorendszeri endoszkópia. / Székely, Hajnal; Tulassay, Zsolt.

In: Orvosi Hetilap, Vol. 150, No. 12, 01.03.2009, p. 541-548.

Research output: Contribution to journalArticle

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