Display options
Cite
Ono S, Myojo M, Harada H, et al. Is it possible to perform gastric endoscopic submucosal dissection without discontinuation of a single antiplatelet of thienopyridine derivatives?. Endosc Int Open. 2017;5(9):E943-E949doi: 10.1055/s-0043-116381.
Ono, S., Myojo, M., Harada, H., Tsuji, K., Murakami, D., Suehiro, S., Doyama, H., Ando, J., Saito, I., Fujishiro, M., Komuro, I., & Koike, K. (2017). Is it possible to perform gastric endoscopic submucosal dissection without discontinuation of a single antiplatelet of thienopyridine derivatives?. Endoscopy international open, 5(9), E943-E949. https://doi.org/10.1055/s-0043-116381
Ono, Satoshi, et al. "Is it possible to perform gastric endoscopic submucosal dissection without discontinuation of a single antiplatelet of thienopyridine derivatives?." Endoscopy international open vol. 5,9 (2017): E943-E949. doi: https://doi.org/10.1055/s-0043-116381
Ono S, Myojo M, Harada H, Tsuji K, Murakami D, Suehiro S, Doyama H, Ando J, Saito I, Fujishiro M, Komuro I, Koike K. Is it possible to perform gastric endoscopic submucosal dissection without discontinuation of a single antiplatelet of thienopyridine derivatives?. Endosc Int Open. 2017 Sep;5(9):E943-E949. doi: 10.1055/s-0043-116381. Epub 2017 Sep 13. PMID: 28924604; PMCID: PMC5597936.
Copy Download .nbib Format: NLM
Share it on

Endosc Int Open. 2017 Sep;5(9):E943-E949. doi: 10.1055/s-0043-116381. Epub 2017 Sep 13.

Is it possible to perform gastric endoscopic submucosal dissection without discontinuation of a single antiplatelet of thienopyridine derivatives?.

Endoscopy international open

Satoshi Ono, Masahiro Myojo, Hideaki Harada, Kunihiro Tsuji, Daisuke Murakami, Satoshi Suehiro, Hisashi Doyama, Jiro Ando, Itaru Saito, Mitsuhiro Fujishiro, Issei Komuro, Kazuhiko Koike

Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
  2. Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
  3. Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan.
  4. Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
  5. Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

PMID: 28924604 PMCID: PMC5597936 DOI: 10.1055/s-0043-116381

Abstract

BACKGROUND AND STUDY AIMS : Combined use of thienopyridine derivatives and other antithrombotic agents is reported to be a risk factor for postoperative bleeding after gastric endoscopic submucosal dissection (ESD). However, risk associated with a single thienopyridine derivative has not been evaluated. In this study, we aimed to evaluate bleeding risks of gastric ESD without discontinuation of a single thienopyridine derivative agent.

PATIENTS AND METHODS:  This multicenter, prospective, observational cohort study included patients who had undergone implantation of a coronary artery stent and who were taking a combination of aspirin antiplatelet therapy and a thienopyridine derivative agent. Enrolled patients discontinued aspirin and underwent gastric ESD without the discontinuation of a single thienopyridine derivative agent. The primary endpoint was the major bleeding complication rate after gastric ESD.

RESULTS:  Eleven patients were enrolled in this study from April 2015 to November 2016 after written informed consent was obtained. Among them, 1 patient, who had undergone surgery for a primary cardiac tumor before ESD, was excluded from the study. Ten patients underwent gastric ESD for neoplasms. En-bloc resections were achieved in all cases without intraoperative bleeding complications. Two patients experienced postoperative bleeding although neither case required a blood transfusion (95 % CI 2.5 - 55.6 %).

CONCLUSION:  En-bloc resections were possible although the postoperative bleeding rate tended to be higher in gastric ESD without discontinuation of a single thienopyridine derivative agent. Additional preventive measures are mandatory to carry out safe gastric ESD in such settings.

References

  1. Clin Endosc. 2014 Sep;47(5):398-403 - PubMed
  2. Endoscopy. 2012;44 Suppl 2 UCTN:E414-5 - PubMed
  3. BMJ. 2006 Oct 7;333(7571):726 - PubMed
  4. J Gastroenterol. 2009;44(12):1185-9 - PubMed
  5. Gastrointest Endosc Clin N Am. 2014 Apr;24(2):245-55 - PubMed
  6. Dig Endosc. 2014 Jan;26(1):1-14 - PubMed
  7. Endoscopy. 2009 Feb;41(2):118-22 - PubMed
  8. Dig Endosc. 2017 Jan;29(1):57-64 - PubMed
  9. Gastric Cancer. 2014;17(3):489-96 - PubMed
  10. Lancet. 2013 Mar 30;381(9872):1107-15 - PubMed
  11. BMJ. 1994 Jan 8;308(6921):81-106 - PubMed
  12. Endoscopy. 2015 Jul;47(7):632-7 - PubMed
  13. Gastrointest Endosc. 2014 Jan;79(1):151-5 - PubMed
  14. Stroke. 2014 Dec;45(12):3754-832 - PubMed
  15. Ann Gastroenterol. 2012;25(4):281-290 - PubMed
  16. Aliment Pharmacol Ther. 2016 Sep;44(6):583-91 - PubMed
  17. Dig Endosc. 2013 Mar;25 Suppl 1:71-8 - PubMed
  18. J Korean Med Sci. 2007 Dec;22(6):1055-9 - PubMed
  19. Circ Cardiovasc Interv. 2016 Jan;9(1):e002816 - PubMed
  20. Circulation. 2007 Feb 13;115(6):813-8 - PubMed
  21. Gastrointest Endosc Clin N Am. 2014 Apr;24(2):213-33 - PubMed

Publication Types