PMID- 34466365
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210903
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 9
DP  - 2021 Sep
TI  - Risk of bleeding following double balloon enteroscopy in patients on continued 
      antiplatelet and/or anticoagulation therapy.
PG  - E1397-E1403
LID - 10.1055/a-1499-6988 [doi]
AB  - Background and study aims  Anticoagulation (AC) and antiplatelet (AP) therapy may 
      increase the risk of gastrointestinal bleeding after double balloon enteroscopy 
      (DBE); however, limited data are currently available regarding the incidence. The 
      aim of this study was to assess the incidence and clinical characteristics of 
      post-DBE bleeding in patients on AC and AP therapy. Patients and methods  The 
      medical records of patients who underwent DBE between 2009 and 2013 at Mayo 
      Clinic, Florida, were retrospectively reviewed. Patients were divided into three 
      groups: 1) continued AP therapy; 2) AC therapy; and 3) neither AP nor AC at the 
      time of DBE. Follow-up data were collected at 60 days and 1 year. Results  A 
      total of 683 patients were identified; 43 on AC, 183 on AP and 457 not on AP or 
      AC therapy. The most common indication for DBE was obscure gastrointestinal 
      bleeding in the groups on and not on AP (85.3 % vs 70.9 %, P  < 0.0001). There 
      was no statistical difference in post-DBE bleeding rates in patients on AP vs not 
      on AP at 60 days (11.5 % vs 7.5 %, P  = 0.12) or 1 year (19.9 % vs 15.7 %, P 
       = 0.23). Rates of bleeding in patients on AC were 11.6 % within 60 days and 
      22.5 % within 1 year. Multivariate analysis reflected American Society of 
      Anesthesiologist > 3 and indication for DBE of GI bleeding were independent risk 
      factors for post-DBE bleeding within 1 year. Conclusions  Continued antiplatelet 
      use at the time of DBE was not an independent risk factor for bleeding post-DBE 
      at 60 days or 1 year of follow up.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Zaver, Himesh B
AU  - Zaver HB
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Ghoz, Hassan
AU  - Ghoz H
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Stancampiano, Fernando
AU  - Stancampiano F
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Alnahhal, Khaled I
AU  - Alnahhal KI
AD  - Division of Vascular Surgery, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Malviya, Balkishan
AU  - Malviya B
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Patel, Krupa
AU  - Patel K
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Rodriguez, Andrea C
AU  - Rodriguez AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Oberoi, Mansi
AU  - Oberoi M
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Koralewski, Andrea
AU  - Koralewski A
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Crawford, Matthew J
AU  - Crawford MJ
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Choudhry, Aruj
AU  - Choudhry A
AD  - Division of Gastroenterology, Fox Chase Cancer Center, Philadelphia, 
      Pennsylvania, United States.
FAU - Mareth, Karl
AU  - Mareth K
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Werlang, Monia E
AU  - Werlang ME
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Kroner, Paul T
AU  - Kroner PT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Simons-Linares, C Roberto
AU  - Simons-Linares CR
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Lukens, Frank
AU  - Lukens F
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Bartel, Michael J
AU  - Bartel MJ
AD  - Division of Gastroenterology, Fox Chase Cancer Center, Philadelphia, 
      Pennsylvania, United States.
FAU - Stark, Mark
AU  - Stark M
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Brahmbhatt, Bhaumik
AU  - Brahmbhatt B
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20210823
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8382496
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/02 06:01
PMCR- 2021/08/01
CRDT- 2021/09/01 07:24
PHST- 2021/02/12 00:00 [received]
PHST- 2021/04/25 00:00 [accepted]
PHST- 2021/09/01 07:24 [entrez]
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2021/09/02 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1055/a-1499-6988 [doi]
PST - epublish
SO  - Endosc Int Open. 2021 Aug 23;9(9):E1397-E1403. doi: 10.1055/a-1499-6988. 
      eCollection 2021 Sep.