ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding Day One | April 2022-08_Management_Anti-Thrombotic Agents_Pts Undergoing Endo

08_Management_Anti-Thrombotic Agents_Pts Undergoing Endo - Enslin

Pdf Summary

This document summarizes the content of a presentation or course on the management of antithrombotic agents in patients undergoing gastrointestinal (GI) endoscopy. The presenter reviews the bleeding risk of different endoscopic procedures, the cardio-neurovascular risk stratification, and the use of various antithrombotic agents including warfarin, antiplatelet therapy, and direct acting oral anticoagulants (DOACs). The guidelines and recommendations mentioned include the ACG/CAG Guideline and the ASGE SOP Guideline.<br /><br />The document discusses the nature of the procedure, the bleeding risk, and the cardio-neurovascular risk as factors to consider when managing antithrombotic agents. It also provides information on specific antithrombotic agents such as warfarin, DOACs, and antiplatelet drugs, including when to stop these medications before a procedure and when to resume them afterward. The management of antithrombotic agents in patients with gastrointestinal bleeding and the need for urgent procedures is also addressed, with recommendations for multidisciplinary consultation and urgent endoscopic evaluation.<br /><br />The document emphasizes the importance of a patient-centered, multidisciplinary approach to antithrombotic management, involving gastroenterologists, hematologists, neurologists, cardiologists, vascular surgeons, oncologists, and GI clinic nurses. It suggests considering the indication for the procedure, the potential harm from not doing or delaying the procedure, and the predictability of catastrophic and inevitable risks when making decisions about continuing or stopping antithrombotic agents.<br /><br />Practice pearls include recommendations for managing low and high bleeding and thromboembolic risks, coordinating with other providers, continuing aspirin therapy, and restarting medications as soon as possible post-procedure. The document also includes polling questions to test the reader's knowledge on the topic.<br /><br />Overall, this document provides a comprehensive overview of the management of antithrombotic agents in patients undergoing GI endoscopy, highlighting important considerations, guidelines, and recommendations to guide clinical practice.<br /><br />Word count: 300 words

Keywords

antithrombotic agents

management

gastrointestinal endoscopy

bleeding risk

cardio-neurovascular risk stratification

warfarin

antiplatelet therapy

direct acting oral anticoagulants

ACG/CAG Guideline

ASGE SOP Guideline