Endoscopy 2011; 43(5): 445-461
DOI: 10.1055/s-0030-1256317
Guidelines

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline

C.  Boustière1 , A.  Veitch2 , G.  Vanbiervliet3 , P.  Bulois4 , P.  Deprez5 , A.  Laquiere1 , R.  Laugier6 , G.  Lesur7 , P.  Mosler8 , B.  Nalet9 , B.  Napoleon10 , B.  Rembacken11 , N.  Ajzenberg12 , J.  P.  Collet13 , T.  Baron14 , J.-M.  Dumonceau15
  • 1Department of Digestive Endoscopy, Hôpital Saint Joseph, Marseille, France
  • 2Endoscopy and Bowel Cancer Screening, New Cross Hospital, Wolverhampton, UK
  • 3Department of Gastroenterology and Endoscopy, Hôpital universitaire l’Archet, Nice, France
  • 4Service de Pathologie Digestive, Hôpital Saint Philibert, Lomme, France
  • 5Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
  • 6Department of Gastroenterology and Endoscopy, Hôpital de la Timone, Marseille, France
  • 7Department of Digestive Endoscopy, Hôpital Ambroise Paré, Paris, France
  • 8Division of Gastroenterology, University of Kentucky Medical Center, Lexington, Kentucky, USA
  • 9Department of Gastroenterology, Hôpital de Montélimar, Montélimar, France
  • 10Department of Endoscopy, Hôpital Jean Mermoz, Lyon, France
  • 11Department of Gastroenterology, The General Infirmary at Leeds, Leeds, UK
  • 12Département d’Hématologie, AP-HP, Hôpital Bichat, INSERM, U698; Université Paris 7 Denis Diderot, Paris, France
  • 13Institut de Cardiologie – INSERM U 937, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
  • 14Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  • 15Service of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland
Further Information

Publication History

submitted 15 December 2010

accepted after revision 21 December 2010

Publication Date:
04 May 2011 (online)

With the increasing use of antiplatelet agents (APA), their management during the periendoscopic period has become a more common and more difficult problem. The increase in use is due to the availability of new drugs and the widespread use of drug-eluting coronary stents. Acute coronary syndromes can occur when APA therapy is withheld for noncardiovascular interventions. Guidelines about APA management during the periendoscopic period are traditionally based on assessments of the procedure-related risk of bleeding and the risk of thrombosis if APA are stopped. New data allow better assessment of these risks, of the necessary duration of APA discontinuation before endoscopy, of the use of alternative procedures (mostly for endoscopic retrograde cholangiopancreatography [ERCP]), and of endoscopic methods that can be used to prevent bleeding (following colonic polypectomy). This guideline makes graded, evidence-based, recommendations for the management of APA for all currently performed endoscopic procedures. A short summary and two Tables are included for quick reference.

Supporting informationThe following material is available online

References

J.-M. Dumonceau, MD, PhD 

Service of Gastroenterology and Hepatology
Geneva University Hospitals

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