ArticleDigestion2026
Association between Antithrombotic Drug Management and Bleeding during High-Risk Endoscopic Procedures: A Multicenter Retrospective Observational Study.
Article in Digestion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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24 authors.
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Abstract
introductionOptimal management of antithrombotic drugs (ATDs) is essential to minimize bleeding during high-risk endoscopic procedures. This study aimed to investigate periprocedural ATD strategies to reduce 30-day post-procedural bleeding.
methodsWe performed a multicenter, retrospective cohort study on high-risk endoscopic procedures. The primary outcome was 30-day bleeding requiring endoscopic hemostasis. We categorized the peri-procedure management of ATDs into continuation, discontinuation, and replacement. We evaluated the risk differences in 30-day bleeding among ATD management groups, as compared to patients who did not take ATDs (nonusers).
resultsHigh-risk upper-GI procedures included 1,365 esophageal ESDs, 788 elective EVLs, 5,391 gastric ESDs, and 2,562 PEGs; lower-GI procedures included 23,326 colonic polypectomy/EMRs and 2,769 colonic ESDs. ATD management included aspirin continuation (n = 818) and discontinuation (n = 62); thienopyridine discontinuation (n = 188) and replacement (n = 97); warfarin continuation (n = 97) and discontinuation (n = 20); DOAC discontinuation (n = 487). Thirty-day bleeding occurred in 5.89% of upper-GI and 1.22% of lower-GI procedures. Bleeding risk differed according to ATD management. In upper-GI procedures, numerically higher bleeding rates were observed in some antithrombotic management groups, particularly aspirin continuation and thienopyridine discontinuation during gastric ESD, compared with nonusers; however, the absolute risk differences were within 10%. In contrast, bleeding risk differences in lower-GI procedures were smaller overall and within 5%.
conclusionThis multicenter study describes differential bleeding risk patterns across high-risk endoscopic procedures among patients receiving antithrombotic therapy.
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