• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Discontinuation of Antiplatelet Therapy for Colonoscopy and the Associated Thromboembolic Risk

Izi D Obokhare, MD, Jose Cordova, MD, David E Beck, MD FACS, Charles B Whitlow, MD FACS, David , A Margolin, MD FACS. Department of Colon and Rectal Surgery Ochsner Medical Center

 

Introduction:
Discontinuation of antiplatelet therapy (APT) is associated with a low risk of thromboembolic events. There is a dearth of data to guide the management of antiplatelet therapy in patients undergoing colonoscopy. Current guidelines are based on small trials and expert opinion. The decision to withhold APT in the periendoscopic period is not a trivial one.

Methods and procedures:
A prospectively collected data base involving 4049 colonoscopies performed in a 10 month period between November 2010 and August 2011 was reviewed. 122 patients on APT were identified. Our current protocol involves checking with prescriber and if safe stopping the clopidogrel for 7 days prior to colonoscopy and restarting immediately after the procedure if no therapeutic maneuvers are performed. If polypectomy is performed we continue to hold the clopidogrel for 3 days. The length of time off clopidogrel prior to and after colonoscopy was recorded. Exclusion criteria included patients who continued clopidogrel use and patients on clopidogrel and coumadin. Patient demographics, and post procedural complications were recorded. The primary endpoint was thromboembolic events and the secondary endpoint was clinically significant hemorrhage within 60 days of clopidogrel interruption.

Results
Out of 4049 patients, 122 were eligible for the study, 70 % were male and 60 % < 70 yrs old. 80% of the patients were on aspirin and clopidogrel, while 20% were on clopidogrel only. Of the patient population, 40 % had stents and 14% had a history of cerebrovascular event. The mean time off APT prior to colonoscopy was 6 ± 2 days, and after colonoscopy was 2 ±1.7 days for both groups of patients with thromboembolic events (TE) and without thromboembolic complication (NTE). P = 0.39 and 0.47 respectively.
The incidence of all thromboembolic complications was 5.7%, and the incidence of bleeding requiring hospitalization and transfusion of blood products was 4.9%.
Comparing the subgroup of patients with a clinically significant hemorrhage with the rest of the cohort, the mean duration of APT was similar: 6 days prior and 1 day post colonoscopy. P = 0.36 and 0.37 respectively.

Conclusion(s)
Discontinuation of antiplatelet medication can be safely done in patients without any major thromboembolic events such as stroke or pulmonary embolism. Minor thromboembolic events were noted such as NSTEMI and thrombosis of grafts and superficial venous thrombosis. There were no strokes noted in the study population and thromboembolic events were classified as mild. The risk of bleeding in this patient population can be significant requiring hospitalization.

Key words: Post polypectomy bleeding, clopidogrel, antiplatelet therapy and colonoscopy.
 


Session Number: Poster – Poster Presentations
Program Number: P051
View Poster

2,834

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons