Should patients on warfarin for 3 months for idiopathic proximal deep venous thrombosis receive bridging therapy precolonoscopy (with expected biopsy)?
A 63-year-old woman presents to discuss periprocedure anticoagulation management. She has been on oral warfarin with an international normalized ratio between 2 and 3 for the past 3 months because of an idiopathic left popliteal vein thrombosis. A colonic polyp was identified during her purely diagnostic colonoscopy performed as part of her age- and gender-appropriate cancer screening. Immediate repeat colonoscopy with polypectomy is recommended. The clinician is asked to provide periprocedural anticoagulation recommendations.
Brotman
Daniel J
DJ
Department of General Internal Medicine, The Cleveland Clinic Foundation, 9500 Euclid Avenue, E13, Cleveland, OH 44195, USA. brotmad@ccf.org
Kaatz
Scott
S
D000925:Anticoagulants / Q000008:administration & dosage*; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D011152:Popliteal Vein; D011300:Preoperative Care; D020246:Venous Thrombosis / Q000188:drug therapy*; D014859:Warfarin / Q000008:administration & dosage*
D000925:Anticoagulants; D014859:Warfarin