Polypectomies et mucosectomies difficiles Coloscopie, anticoagulants et antiagregants : quand les arreter et quand les reprendre ? Coloscopy, anticoagulants and anti-platelet agents: when should they be stopped and resumed?

摘要

The increasing number of patients taking anticoagulants (ACG) or anti-platelet agents (APA) poses some specific problems for colonoscopic examinations. In fact, no examinations are performed under ACG, except in an emergency, but only after a drug adaptation consisting generally of a brief relay by heparin. In this situation, the real risk is the increased rate of delayed bleeding after polypectomy. In contrast, it is possible to realize colonosco-pies with biopsies or even polypectomies for polyps of less than 1 cm without stopping aspirin in some patients with high thrombotic risk (more often coronary drug eluting stents) for whom it is not advisable to interrupt the AAP. In all cases, we must underline the importance of a multi-speciality management of the patients under ACG or AAP, the need of a complete information and a post-procedure survey adapted to the increased bleeding risk.