Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy

  • Seung Joo Kang (Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Chung Hyun Tae (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Chang Seok Bang (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Cheol Min Shin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Young-Hoon Jeong (CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Miyoung Choi (National Evidence-Based Healthcare Collaborating Agency) ;
  • Joo Ha Hwang (Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University) ;
  • Yutaka Saito (Endoscopy Division, National Cancer Center Hospital) ;
  • Philip Wai Yan Chiu (Division of Upper GI and Metabolic Surgery, Department of Surgery, The Chinese University of Hong Kong) ;
  • Rungsun Rerknimitr (Division of Gastroenterology, Department of Medicine, Chulalongkorn University) ;
  • Christopher Khor (Department of Gastroenterology and Hepatology, Singapore General Hospital and Duke-NUS Medical School) ;
  • Vu Van Khien (Departments of GI Endoscopy, 108 Central Hospital) ;
  • Kee Don Choi (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ki-Nam Shim (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Geun Am Song (Department of Internal Medicine, Pusan National University Hospital, Pusan National University College of Medicine and Biomedical Research Institute) ;
  • Oh Young Lee (Department of Internal Medicine, Hanyang University School of Medicine)
  • Received : 2023.12.28
  • Accepted : 2024.02.09
  • Published : 2024.03.30
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Abstract

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Keywords

Acknowledgement

We thank the executive members of the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Cardiology, the Korean Neurological Association, the Korean Society of Gastroenterology, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Disease, and the Korean Pancreatobiliary Association for reviewing the manuscript and providing expert opinions.

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