Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions

Figure 1 Flow chart summarizing the cessation and restart of antithrombotic drugs in endoscopic submucosal dissection (ESD)[6]. Warfarin is discontinued before ESD and heparin is initiated if needed. PT-INR is checked 3 to 4 d later; if PT-INR ≤ 1.5, ESD can be performed. After surgery warfarin is immediately restarted, and heparin is co-administered in patients at high risk for disease. Antiplatelet drugs are discontinued before ESD as well (aspirin, 3 d before ESD; ticlopidine, 5 d before ESD); they are immediately restarted after the procedure. PT-INR: Prothrombin time-international normalized ratio.

Figure 2 The margin and center areas of the ulcer floor. The margin includes the outer 5 mm edge of the ulcer, and the remaining area is defined as the center.