| Theme |
Management of antithrombotic agents for colorectal endoscopic procedures -- Validity of new guideline by Japan Gastroenterological Endoscopy Society |
| Title |
Cilostazol/aspirin bridging therapy in periendoscopic period |
| Author |
Katsuhiro Mabe |
Department of Cancer Preventive Medicine, Hokkaido University Graduate School of Medicine |
| Author |
Mototsugu Kato |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Shoko Ono |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Yuichi Shimizu |
Department of Cancer Preventive Medicine, Hokkaido University Graduate School of Medicine / Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine |
| Author |
Naoya Sakamoto |
Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine |
| [ Summary ] |
The new edition of the guidelines for managing antithrombotic agents during periendoscopic periods has been produced by the Japan Gastroenterological Endoscopy Society. It recommends that all antiplatelet agents be continued for low bleeding risk endoscopic procedures. For high thrombotic risk patients, it also recommended that aspirin should be maintained and thienopyridine should be exchanged for cilostazol or aspirin as a bridging therapy in cases of high bleeding risk endoscopic procedures. Colonoscopic treatment, including polypectomy, endoscopic mucosal resection and endoscopic submucosal dissection, is categorized in the high bleeding risk group. Thienopyridine should be replaced by cilostazol or aspirin in patients at high risk of thromboembolism. If possible, colonoscopic treatment should be postponed until anti-platelet agents can be withdrawn. According to need, the procedures should be carried out with special caution to avoid bleeding. |