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

Table 46 Endoscopic submucosal dissection

Ref.	Year	Country	Study design	n	Procedure	Medication	Relative risk
Igarashi et al[56]	2017	Japan	Retrospective	67	ESD	Warfarin ± HBT either: (1) Received till day of; (2) Ceased 3-7 d before; (3) HBT 3-7 d before	Incidence of PPB 10.0% (warfarin and DOAC combined). Incidence of PPB 10.8% (HBT group)
Sato et al[57]	2017	Japan	Retrospective	93	ESD	Warfarin ± HBT (ceased 3-5 d before)	Incidence of PPB 5.9% (without HBT). Incidence of PPB (with HBT) 30.7%
Furuhata et al[115]	2017	Japan	Retrospective	253	ESD	Warfarin ± HBT (ceased 3-4 d before)	Incidence of PPB 7.3% (Warfarin and DOAC combined). Incidence of PPB 28.8% (with HBT)
Yoshio et al[132]	2017	Japan	Retrospective	97	ESD	Warfarin ± HBT (ceased 4-5 d before)	No incidence of PPB (without HBT). Incidence of PPB (with HBT) 31.6%
Harada et al[136]	2017	Japan	Prospective	45	ESD	Warfarin ± HBT either: (1) Continued; (2) Switched to HBT	Incidence of PPB 9.1% (warfarin continued). Incidence of PPB 21.7% (HBT)
Kono et al[58]	2018	Japan	Retrospective	872	ESD	Warfarin ± HBT (ceased 1-3 d before with or without HBT)	Incidence of PPB 6.4% (without HBT). Incidence of PPB 29% (with HBT) (warfarin and DOACs combined)
Yamashita et al[60]	2018	Japan	Retrospective	650	ESD	Warfarin with HBT	Incidence of PPB 26.3% (with HBT)
Nam et al[118]	2019	South Korea	Retrospective	1942	ESD	Warfarin ± HBT (ceased 7 d before)	Incidence of PPB 3.2%
Harada et al[61]	2020	Japan	Retrospective	26	ESD	Warfarin ± HBT either: (1) Continued; (2) Ceased 4-5 d ± HBT before	Incidence of PPB 7.7%

ESD: Endoscopic submucosal dissection; HBT: Heparin bridging therapy; PPB: Post-procedural bleeding; DOAC: Direct oral anticoagulant.