How Should Patients Requiring Dual Antiplatelet Therapy be Managed When Undergoing Elective Endoscopic Gastrointestinal Procedures?


Journal Article

OPINION STATEMENT: The following are general guidelines for the management of patients on dual antiplatelet therapy as they undergo gastrointestinal procedures with potential for bleeding complications: Avoid cessation of all antiplatelet therapies after percutaneous coronary intervention (PCI) with stent placement when possible. Avoid cessation of clopidogrel (even when aspirin is continued) within the first 30 days after PCI and either drug-eluting stent (DES) or bare metal stent placement. Defer elective endoscopic procedures, possibly up to 12 months, if clinically acceptable from the time of PCI and DES placement. Perform endoscopic procedures, particularly those associated with bleeding risk, 5 to 7 days after thienopyridine drug cessation. Aspirin should be continued when possible. Resume thienopyridine and aspirin drug therapy after the procedure once hemostasis is achieved. A loading dose of the former should be considered among patients at risk for thrombosis. Continue platelet-directed therapy in patients undergoing elective endoscopy procedures associated with a low risk for bleeding.

Full Text

Duke Authors

Cited Authors

  • Sherwood, MW; Wang, TY; Becker, RC

Published Date

  • February 2011

Published In

Volume / Issue

  • 13 / 1

Start / End Page

  • 46 - 56

PubMed ID

  • 21136215

Pubmed Central ID

  • 21136215

Electronic International Standard Serial Number (EISSN)

  • 1534-3189

Digital Object Identifier (DOI)

  • 10.1007/s11936-010-0107-4


  • eng

Conference Location

  • United States