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Risk of Bleeding with Endoscopic Ultrasound-Guided Tissue Acquisition in Patients on Antithrombotic Therapy: A Systematic Review and Meta-Analysis.
- Source :
-
Digestive Diseases & Sciences . May2023, Vol. 68 Issue 5, p1950-1958. 9p. - Publication Year :
- 2023
-
Abstract
- Background: The present guidelines stratify endoscopic ultrasound-guided tissue acquisition (EUS-TA) as a high-bleeding risk procedure in patients on antithrombotics. However, the data regarding the same are conflicting. Therefore, this meta-analysis aimed to analyze the bleeding event rates associated with EUS-TA in patients receiving antithrombotic therapy. Methods: A literature search from January 2000 to August 2022 was done for studies on EUS-guided TA in patients receiving antithrombotics. The primary outcome was incidence of overall and major bleeding. Pooled event rates across studies were expressed with summative statistics. Results: A total of 12 studies were included in the meta-analysis. The pooled risk of overall bleeding and major bleeding in patients on antithrombotics was 2.0% (0.6–3.4) and 0.8% (0.0–1.6), respectively. In patients taking thienopyridine or anticoagulants, the pooled risk of overall bleeding and major bleeding was 2.4% (0.9–3.9) and 1.7% (0.4–3.1), respectively. Patients on antithrombotics had a higher odd of overall bleeding (OR 2.12, 1.20–3.83) and major bleeding (OR 3.58, 1.11–11.52) compared to controls. The odds of overall bleeding (OR 0.95, 95%CI 0.38–2.42) and major bleeding (OR 1.57, 95%CI 0.45–5.54) were comparable between patients on antithrombotics who continued and those who discontinued it preprocedural. Conclusion: Despite an increase risk of bleeding with EUS-TA in patients on antithrombotics, the pooled incidence remains low. Compared to the previous guidelines stating thienopyridine use as high risk for bleeding, the present analysis showed a bleeding rate of less than 1%. Discontinuing antithrombotics prior to EUS-TA does not reduce the bleeding risk significantly, requiring strict monitoring. [ABSTRACT FROM AUTHOR]
- Subjects :
- *FIBRINOLYTIC agents
*HEMORRHAGE
Subjects
Details
- Language :
- English
- ISSN :
- 01632116
- Volume :
- 68
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Digestive Diseases & Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 163334251
- Full Text :
- https://doi.org/10.1007/s10620-022-07808-x