A Prospective Multicenter Study Evaluating Bleeding Risk after Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients Prescribed Antithrombotic Agents
Kazumichi Kawakubo,
Kei Yane,
Kazunori Eto,
Hirotoshi Ishiwatari,
Nobuyuki Ehira,
Shin Haba,
Ryusuke Matsumoto,
Keisuke Shinada,
Hiroaki Yamato,
Taiki Kudo,
Manabu Onodera,
Toshinori Okuda,
Yoko Taya-Abe,
Shuhei Kawahata,
Kimitoshi Kubo,
Yoshimasa Kubota,
Masaki Kuwatani,
Hiroshi Kawakami,
Akio Katanuma,
Michihiro Ono,
Tsuyoshi Hayashi,
Minoru Uebayashi,
Naoya Sakamoto
Affiliations
Kazumichi Kawakubo
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Kei Yane
Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
Kazunori Eto
Department of Gastroenterology, Tomakomai City Hospital, Tomakomai, Japan
Hirotoshi Ishiwatari
Department of Medical Oncology and Hematology, Sapporo Medical University, Sapporo, Japan
Nobuyuki Ehira
Department of Gastroenterology, Japanese Red Cross Kitami Hospital, Kitami, Japan
Shin Haba
Department of Gastroenterology, NTT East Sapporo Hospital, Sapporo, Japan
Ryusuke Matsumoto
Department of Gastroenterology, Obihiro Kosei Hospital, Obihiro, Japan
Keisuke Shinada
Department of Gastroenterology, Keiwakai Ebetsu Hospital, Ebetsu, Japan
Hiroaki Yamato
Department of Gastroenterology and Hepatology, Hakodate City Hospital, Hakodate, Japan
Taiki Kudo
Department of Gastroenterology, Kushiro Rosai Hospital, Kushiro, Japan
Manabu Onodera
Department of Gastroenterology, NTT East Sapporo Hospital, Sapporo, Japan
Toshinori Okuda
Department of Gastroenterology, Oji General Hospital, Tomakomai, Japan
Yoko Taya-Abe
Department of Gastroenterology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
Shuhei Kawahata
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Kimitoshi Kubo
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Yoshimasa Kubota
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Masaki Kuwatani
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Hiroshi Kawakami
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Akio Katanuma
Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
Michihiro Ono
Department of Medical Oncology and Hematology, Sapporo Medical University, Sapporo, Japan
Tsuyoshi Hayashi
Department of Medical Oncology and Hematology, Sapporo Medical University, Sapporo, Japan
Minoru Uebayashi
Department of Gastroenterology, Japanese Red Cross Kitami Hospital, Kitami, Japan
Naoya Sakamoto
Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Background/Aims Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrom-botic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. Methods : Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed. Results : Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation. Conclusion : s The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable.
