[MANAGEMENT OF ANTICOAGULANT AND ANTIPLATELET THERAPY IN PATIENTS UNDERGOING PLANNED ENDOSCOPIC PROCEDURES]

Abstract

Antithrombotic and antiplatelet therapy is widely used for primary and secondary prevention of venous and arterial diseases. Hemorrhage is a frequent complication in patients taking these drugs, especially during and post invasive procedures. There are several oral anticoagulants and antiplatelet drugs that differ from each other in the mechanism of action and metabolism, the need for drug monitoring, antidote, and the peri-procedural management of the drug. The risk of bleeding in gastrointestinal endoscopic procedures can be high (≥ 1.5%), depending on the procedure. Patients taking antithrombotic and antiplatelet therapy should undergo evaluation before endoscopic procedure in order to stratify their risk for bleeding during the procedure on the one hand, and the risk of thromboembolism- if the drug is interrupted, on the other hand. This review provides general recommendations and approaches for patients undergoing elective gastrointestinal endoscopic procedures while receiving antithrombotic or antiplatelet drugs.