title: A prospective control study of the safety and cellular yield of EUS-guided FNA or Trucut biopsy in patients taking aspirin, nonsteroidal anti-inflammatory drugs, or prophylactic low molecular weight heparin.
abstract: BACKGROUND
  Although the ASGE recommends that high-risk endoscopic procedures can safely be performed on patients taking aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) in standard doses, there is a paucity of data on EUS-FNA per se in this setting.
  
  
  OBJECTIVE
  We studied the safety and cellular yield of EUS-FNA and/or Trucut biopsy (TCB) in patients taking aspirin, NSAIDS, or prophylactic low molecular weight heparins (LMWH).
  
  
  METHODS
  Prospective control study.
  
  
  METHODS
  Consecutive patients undergoing EUS-FNA and/or TCB were recruited over an 18-month period. The usage of aspirin, NSAIDS, or LMWH were recorded and patients who were not taking these medications served as controls.
  
  
  METHODS
  The bleeding events (endosonographic findings of extraluminal bleeding, intraluminal bleeding requiring hemostatic procedures, hematemesis, or melena) and cellular yield were compared between patients and controls.
  
  
  RESULTS
  Two hundred fourteen patients (8 had repeat procedures) underwent EUS-FNA and/or TCB on 241 lesions. Bleeding events occurred in none (0 of 26), 33.3% (2 of 6), and 3.7% (7 of 190) of the patients in the aspirin/NSAIDS, LMWH, and control groups, respectively (p = 0.023). The mean numbers of FNA passes, applications of suction, bloody specimens, and cellular yield were not significantly different between patients who were or were not receiving medications. No significant difference in bleeding events was noted between the FNA and TCB groups.
  
  
  CONCLUSIONS
  EUS-FNA or TCB is safe in patients taking aspirin or NSAIDS. Consideration should be given to stopping LMWH before the procedure. The cellular yield and blood contamination of the specimen from FNA are similar to those in controls.
authors.affiliation: Department of Gastroenterology, Guy's and St. Thomas' Hospitals, London, United Kingdom.
authors.forename: Charles
authors.initials: C
authors.lastname: Kien-Fong Vu
authors.forename: Fuju
authors.initials: F
authors.lastname: Chang
authors.forename: Laura
authors.initials: L
authors.lastname: Doig
authors.forename: John
authors.initials: J
authors.lastname: Meenan
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects; D000075202:Contraindications; D019160:Endosonography; D006470:Hemorrhage / Q000209:etiology; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011446:Prospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin