Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence

Table 45 Endoscopic mucosal resection

Ref.	Year	Country	Study design	n	Polyp morphology	Procedure	Medication	Relative risk
Fujita et al[135]	2018	Japan	Prospective (non-HBT group). Retrospective (HBT group)	43/41	Size: < 10 mm (mean size 7.2-7.8 mm ± 2.2-3.2 mm)	EMR	Warfarin ± HBT (ceased morning of)	No incidence of PPB (non-HBT group). Incidence of PPB 9.8% (HBT group)
Ono et al[113]	2019	Japan	Retrospective	24	Size: Median size ranged from 8.5-9.5 ± 5 mm between groups	EMR	Warfarin ± HBT either: Continued; ceased 3 d before procedure	Incidence of PPB (without HBT) 10%. Incidence of PPB (with HBT) 21.4%
So et al[50]	2019	South Korea	Retrospective	1197	Size: Mean lesion size 34 mm	EMR	Warfarin either: Ceased day of; 0-4 d before; ceased 5-7 d before; ceased 8-14 d before	Incidence of PPB 16.7% (specific PPB rates between warfarin and DOACs N/S). Incidence of PPB (HBT group) 35.7%
Albéniz et al[114]	2020	Spain	Prospective	76	Size: ≥ 20 mm (mean size 30.5 mm)	EMR	Warfarin (ceased 5 d before with HBT)	Increased risk of PPB with anticoagulant use (OR: 4.54, 95%CI: 2.14-9.63, P < 0.001). Incidence of PPB not specified in study

EMR: Endoscopic mucosal resection; HBT: Heparin bridging therapy; PPB: Post-procedural bleeding; N/S: Not stated; OR: Odds ratio.