Gut Liver.
2024 Sep;18(5):764-780. 10.5009/gnl240176.
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
- Kang SJ
1 - Tae CH2
- Bang CS3
- Shin CM4
- Jeong YH5
- Choi M6
- Hwang JH7
- Saito Y8
- Chiu PWY9
- Rerknimitr R10
- Khor C11
- Khien VV12
- Choi KD13
- Shim KN2
- Song GA14
- Lee OY15
- tKSoGETFoCPG
- Affiliations
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- 1Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- 2Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- 3Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
- 4Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 5CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- 6National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
- 7Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, CA, USA
- 8Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
- 9Division of Upper GI and Metabolic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
- 10Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
- 11Department of Gastroenterology and Hepatology, Singapore General Hospital and Duke-NUS Medical School, Singapore
- 12Department of GI Endoscopy, 108 Central Hospital, Hanoi, Vietnam
- 13Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 14Department of Internal Medicine, Pusan National University Hospital, Pusan National University College of Medicine and Biomedical Research Institute, Busan, Korea
- 15Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea
- KMID: 2559085
- DOI: http://doi.org/10.5009/gnl240176
Abstract
- Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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