| Theme | Endoscopic Treatment for Elderly Patients with Gastro‒intestinal Cancer | |
|---|---|---|
| Title | Current Practices Concerning Management of Antithrombotics during the Periendoscopic Period | |
| Publish Date | 2017/06 | |
| Author | Chihiro Minatsuki | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Satoshi Ono | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Itaru Saito | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Nobutake Yamamichi | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Mitsuhiro Fujishiro | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Kazuhiko Koike | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] | Endoscopic procedures play an important role in the clinical management of diseases of the digestive tract, although they are accompanied by risks of bleeding. Therefore, procedural risks must be considered, especially in elderly people receiving antithrombotics because continuation and discontinuation of antithrombotics increases risks of bleeding and thromboembolism, respectively. Present guidelines recommend management of antithrombotics based upon the risk of bleeding, risk of thromboembolic events, comorbidities and number of antithrombotics instituted. Based on current guidelines, endoscopic procedures may be performed even without discontinuation of antithrombotics based on the severity and risk of thromboembolism rather than bleeding, although this guideline is not supported by solid evidence. However, it also enables further accumulate of evidence supporting future‒coming guidelines. In this article, we introduce current practices, problems, and future perspectives concerning management of antithrombotics during the periendoscopic period. | |