Continuous Anticoagulation and Cold Snare Polypectomy
Authors: Erin L. Tompkins, Mary A. Andrews
Journal: Annals of Internal Medicine (2019)

Letters3 December 2019Continuous Anticoagulation and Cold Snare PolypectomyErin L. Tompkins, MD, MPH and Mary A. Andrews, MD, MPHErin L. Tompkins, MD, MPHWalter Reed National Military Medical Center, Bethesda, Maryland (E.L.T., M.A.A.)Search for more papers by this author and Mary A. Andrews, MD, MPHWalter Reed National Military Medical Center, Bethesda, Maryland (E.L.T., M.A.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0672 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Clinicians need data on perioperative anticoagulant therapy (especially direct-acting oral anticoagulants), and we congratulate Takeuchi and colleagues (1) on their contribution to this vital area of research. However, we have some questions about their methods.The authors state, “On the basis of previous reports about warfarin and HB [heparin bridging] … we hypothesized that the incidence of severe bleeding would be 10% in the HB+HSP [HB and hot snare polypectomy] group and 3% in the CA+CSP [continuous administration of anticoagulants and cold snare polypectomy] group.” Given this hypothesis, why was a noninferiority trial performed rather than a ...References1. Takeuchi Y, Mabe K, Shimodate Y, et al; Madowazu Study Group. Continuous anticoagulation and cold snare polypectomy versus heparin bridging and hot snare polypectomy in patients on anticoagulants with subcentimeter polyps. A randomized controlled trial. Ann Intern Med. 2019;171:229-37. [PMID: 31307055]. doi:10.7326/M19-0026 LinkGoogle Scholar2. Acosta RD, Abraham NS, Chandrasekhara V, et al; ASGE Standards of Practice Committee. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016;83:3-16. [PMID: 26621548] doi:10.1016/j.gie.2015.09.035 CrossrefMedlineGoogle Scholar3. Siegal D, Yudin J, Kaatz S, et al. Periprocedural heparin bridging in patients receiving vitamin K antagonists: systematic review and meta-analysis of bleeding and thromboembolic rates. Circulation. 2012;126:1630-9. [PMID: 22912386] CrossrefMedlineGoogle Scholar4. Yong JW, Yang LX, Ohene BE, et al. Periprocedural heparin bridging in patients receiving oral anticoagulation: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2017;17:295. [PMID: 29237411] doi:10.1186/s12872-017-0719-7 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Walter Reed National Military Medical Center, Bethesda, Maryland (E.L.T., M.A.A.)Disclaimer: The views expressed in this comment do not necessarily represent the official policy of the U.S. government, the Department of Defense, Walter Reed National Military Medical Center, or the Uniformed Services University.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0672. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoContinuous Anticoagulation and Cold Snare Polypectomy Versus Heparin Bridging and Hot Snare Polypectomy in Patients on Anticoagulants With Subcentimeter Polyps Yoji Takeuchi , Katsuhiro Mabe , Yuichi Shimodate , Shinji Yoshii , Shinya Yamada , Mineo Iwatate , Takuji Kawamura , Kinichi Hotta , Koji Nagaike , Nobuaki Ikezawa , Tomoaki Yamasaki , Yoriaki Komeda , Satoshi Asai , Yasuhiro Abe , Takuji Akamatsu , Yuko Sakakibara , Hisatomo Ikehara , Yuzuru Kinjo , Takashi Ohta , Yoko Kitamura , Takashi Shono , Takuya Inoue , Yoshio Ohda , Nozomu Kobayashi , Tokuma Tanuma , Ryu Sato , Taku Sakamoto , Naohiko Harada , Akiko Chino , Hideki Ishikawa , Masanori Nojima , Toshio Uraoka , and Continuous Anticoagulation and Cold Snare Polypectomy Yoji Takeuchi , Takuji Kawamura , and Masanori Nojima Metrics Cited byPeriprocedural Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant Undergoing a Digestive Endoscopy 3 December 2019Volume 171, Issue 11Page: 863KeywordsAnticoagulant therapyAnticoagulantsGastroenterology and hepatologyHeart failureHemorrhageHeparinHypertensionPolypectomiesStrokeVascular diseases ePublished: 3 December 2019 Issue Published: 3 December 2019 PDF downloadLoading ...