Cold snare resection safe in patients on continuous clopidogrel and aspirin, suggests study

A new study published in the journal of Gastrointestinal Endoscopy found the safety of cold snare resection in individuals treated with continuous clopidogrel and aspirin. 2 well-established methods for removing colorectal lesions include underwater resection (polypectomy) and conventional endoscopic mucosal resection (EMR).

Despite being a more recent technique, underwater resection is safe and efficient, and it has benefits over traditional EMR, such as quicker resection and lower resource use. One technique that has a significant risk of bleeding is polypectomy. While it is advised to stop taking clopidogrel 5 to 7 days before polypectomy and the guidelines advise continuing to take aspirin throughout the procedure. The cold snare resection technique, with or without submucosal injection, is thought to be safer when compared to traditional polypectomy with electrocoagulation for post-polypectomy bleeding. Thus, Tae-Geun Gweon and colleagues carried out this investigation to compare the bleeding problems linked to cold snare resection between users of aspirin and clopidogrel.

Users of aspirin and clopidogrel who had polypectomy were included in this multicenter, prospective cohort research, which was carried out at 5 university hospitals in Korea. Antiplatelet agents were used continuously, with continuous usage defined as ≤ 3 days of interruption. In contrast to acute bleeding, which required hemostasis 2 minutes after polypectomy, delayed bleeding was the main goal and was defined as bleeding that occurred many hours after polypectomy. For every polyp, risk factors for rapid bleeding were examined.