Management of antithrombotic agents in patients undergoing flexible bronchoscopy

摘要

Bleeding is one of the most feared complications of flexible bronchoscopy. Although infrequent; it can be catastrophic and result in fatal outcomes. Compared to other endoscopic procedures; the risk of morbidity and mortality from the bleeding is increased; as even a small amount of blood can fill the tracheobronchial tree and lead to respiratory failure. Patients using antithrombotic agents (ATAs) have higher bleeding risk. A thorough understanding of the different ATAs is critical to manage patients during the peri-procedural period. A decision to stop an ATA before bronchoscopy should take into account a variety of factors; including indication for its use and the type of procedure. This article serves as a detailed review on the different ATAs; their pharmacokinetics and the pre- and post-bronchoscopy management of patients receiving these medications.