Antiplatelet and/or anticoagulant treatment does not increase hemorrhagic adverse events during EUS-guided biliary drainage.


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 05 03 2020
accepted: 10 04 2020
pubmed: 26 4 2020
medline: 17 3 2021
entrez: 26 4 2020
Statut: ppublish

Résumé

No data appear to have been reported regarding bleeding risk among patients receiving antiplatelet and/or anticoagulant treatment (AP/AC) during EUS-guided biliary drainage (BD) procedures. The aim of this study was to assess whether hemorrhagic adverse events associated with EUS-BD are increased in patients on AP/AC. Patients receiving AP/AC who underwent EUS-BD were retrospectively enrolled between May 2015 and August 2019. Patients who did not receive AP/AC and underwent EUS-BD in the same period were also enrolled as a control group. One hundred ninety-five patients who underwent EUS-BD were enrolled in this study. Among these, 154 patients were allocated to the control group and 41 patients to the AP/AC group. Overall frequency of adverse events did not differ significantly between the control group (16.2%, 25/154) and AC/AP group (17.1%, 6/41; P = .80). The overall bleeding event rate was 3.6% (7/195), with no significant difference between the 2 groups. No thromboembolic events were observed with or without interruption of AP/AC. According to logistic regression analysis, the use of AP/AC was not a risk factor significantly associated with bleeding events (odds ratio, 2.96; 95% confidence interval, .56-14.0; P = .18). On the other hand, a long procedure time (>20 minutes) was an independent risk factor associated with bleeding events. Bleeding events appear to be infrequent among patients who undergo EUS-BD while continuing AP/AC.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
No data appear to have been reported regarding bleeding risk among patients receiving antiplatelet and/or anticoagulant treatment (AP/AC) during EUS-guided biliary drainage (BD) procedures. The aim of this study was to assess whether hemorrhagic adverse events associated with EUS-BD are increased in patients on AP/AC.
METHODS METHODS
Patients receiving AP/AC who underwent EUS-BD were retrospectively enrolled between May 2015 and August 2019. Patients who did not receive AP/AC and underwent EUS-BD in the same period were also enrolled as a control group.
RESULTS RESULTS
One hundred ninety-five patients who underwent EUS-BD were enrolled in this study. Among these, 154 patients were allocated to the control group and 41 patients to the AP/AC group. Overall frequency of adverse events did not differ significantly between the control group (16.2%, 25/154) and AC/AP group (17.1%, 6/41; P = .80). The overall bleeding event rate was 3.6% (7/195), with no significant difference between the 2 groups. No thromboembolic events were observed with or without interruption of AP/AC. According to logistic regression analysis, the use of AP/AC was not a risk factor significantly associated with bleeding events (odds ratio, 2.96; 95% confidence interval, .56-14.0; P = .18). On the other hand, a long procedure time (>20 minutes) was an independent risk factor associated with bleeding events.
CONCLUSIONS CONCLUSIONS
Bleeding events appear to be infrequent among patients who undergo EUS-BD while continuing AP/AC.

Identifiants

pubmed: 32334019
pii: S0016-5107(20)34192-4
doi: 10.1016/j.gie.2020.04.038
pii:
doi:

Substances chimiques

Anticoagulants 0
Platelet Aggregation Inhibitors 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

659-666

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Takeshi Ogura (T)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Nobu Nishioka (N)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Saori Ueno (S)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Tadahiro Yamada (T)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Masanori Yamada (M)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Kazuya Ueshima (K)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Jun Matsuno (J)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Atsushi Okuda (A)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Yoshitaro Yamamoto (Y)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Kazuhide Higuchi (K)

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

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Classifications MeSH