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KMID : 1188320180120030353
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Gut and Liver
2018 Volume.12 No. 3 p.353 ~ p.359
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A Prospective Multicenter Study Evaluating Bleeding Risk after Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients Prescribed Antithrombotic Agents
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Kawakubo Kazumichi
Yane Kei
Eto Kazunori
Ishiwatari Hirotoshi
Ehira Nobuyuki
Haba Shin
Matsumoto Ryusuke
Shinada Keisuke
Yamato Hiroaki
Kudo Taiki
Onodera Manabu
Okuda Toshinori
Taya-Abe Yoko
Kawahata Shuhei
Kubo Kimitoshi
Kubota Yoshimasa
Kuwatani Masaki
Kawakami Hiroshi
Katanuma Akio
Ono Michihiro
Hayashi Tsuyoshi
Uebayashi Minoru
Sakamoto Naoya
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Abstract
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Background/Aims: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrombotic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients.
Methods: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed.
Results: Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation.
Conclusions: The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable.
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KEYWORD
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Endoscopic ultrasound-guided fine needle aspiration, Hemorrhage, Fibrinolytic agents
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