Antithrombotic therapy and gastric EMR or endoscopic submucosal dissection: The bleeding edge?

The number and complexity of endoscopic procedures performed by gastroenterologists and surgeons have increased in parallel with the increasing number of antithrombotic agents in clinical use.1,2 The decision to stop and resume 1 or more of these antithrombotic agents in the periprocedural period is challenging, and one must consider several patient-specific and procedure-specific factors, most notably the indication for antithrombotic use and the bleeding risk associated with the procedure. Acute coronary syndrome and stroke carry high rates of morbidity and mortality and are dreaded adverse events of withholding antithrombotic agents.

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