Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update.
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Authors
Veitch, Andrew
Issue Date
2021-09-01
Journal
Type
Guideline
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Anticoagulants
Gastrointestinal endoscopy
Gastrointestinal haemorrhage
Thrombosis
Thrombosis UK
British Society of Gastroenterology (BSG)
European Society of Gastrointestinal Endoscopy (ESGE)
British Society of Haematology
British Cardiovascular Intervention Society
Anticoagulation UK
Endoscopy
Endoscopic procedures
Anticoagulant therapy
Gastrointestinal endoscopy
Gastrointestinal haemorrhage
Thrombosis
Thrombosis UK
British Society of Gastroenterology (BSG)
European Society of Gastrointestinal Endoscopy (ESGE)
British Society of Haematology
British Cardiovascular Intervention Society
Anticoagulation UK
Endoscopy
Endoscopic procedures
Anticoagulant therapy
Journal Title
Endoscopy
Volume
53
Issue
9
Begin page
947
End page
969
Abstract
This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles, and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.
Citation
Veitch AM, Radaelli F, Alikhan R, Dumonceau JM, Eaton D, Jerrome J, Lester W, Nylander D, Thoufeeq M, Vanbiervliet G, Wilkinson JR, van Hooft JE. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Endoscopy. 2021 Sep;53(9):947-969. doi: 10.1055/a-1547-2282. Epub 2021 Aug 6. PMID: 34359080; PMCID: PMC8390296.