J Korean Med Assoc.  2020 Nov;63(11):711-718. 10.5124/jkma.2020.63.11.711.

Management of antithrombotic agents for gastrointestinal endoscopy

• Lim H

• KMID: 2508756
• DOI: http://doi.org/10.5124/jkma.2020.63.11.711

Abstract

Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. Antithrombotic agents reduce the risk of thromboembolism; however, they increase the risk of bleeding. The management of patients on antithrombotic agents, who are also undergoing endoscopic procedures, has become a common and significant clinical challenge. Decisions regarding the management of antithrombotic agents prior to endoscopic procedures should be made with a comprehensive consideration of the risk of thromboembolism related to the discontinuation of antithrombotic agents, along with the risk of bleeding associated with the endoscopic procedures. Four major endoscopy organizations (American Society of Gastrointestinal Endoscopy, Asian Pacific Association of Gastroenterology/Asian Pacific Society for Digestive Endoscopy, British Society of Gastroenterology/European Society of Gastrointestinal Endoscopy, and Japan Gastroenterological Endoscopy Society) have put-forth clinical practice guidelines to assist gastroenterologists in making decisions regarding the appropriate choice of treatments pertaining to the use of antithrombotic agents before and after endoscopic procedures. This review aimed to analyze the current clinical practice guidelines and provide general recommendations on the management of antithrombotic agents in patients undergoing elective gastrointestinal endoscopy.

Keyword

Anticoagulants; Fibrinolytic agents; Endoscopy; Guidelines; 항응고제; 항혈전제; 내시경검사; 진료지침