title: Colonoscopic polypectomy in anticoagulated patients.
abstract: OBJECTIVE
  To review our experience performing polypectomy in anticoagulated patients without interruption of anticoagulation.
  
  
  METHODS
  Retrospective chart review at the Veterans Affairs Palo Alto Health Care System. Two hundred and twenty five polypectomies were performed in 123 patients. Patients followed a standardized protocol that included stopping warfarin for 36 h to avoid supratherapeutic anticoagulation from the bowel preparation. Patients with lesions larger than 1 cm were generally rescheduled for polypectomy off warfarin. Endoscopic clips were routinely applied prophylactically.
  
  
  RESULTS
  One patient (0.8%, 95% CI: 0.1%-4.5%) developed major post-polypectomy bleeding that required transfusion. Two others (1.6%, 95% CI: 0.5%-5.7%) had self-limited hematochezia at home and did not seek medical attention. The average polyp size was 5.1 +/- 2.2 mm.
  
  
  CONCLUSIONS
  Polypectomy can be performed in therapeutically anticoagulated patients with lesions up to 1 cm in size with an acceptable bleeding rate.
authors.affiliation: Division of Gastroenterology, VA Palo Alto and Stanford University, 3801 Miranda Avenue, Palo Alto, CA 94304, USA. shai_friedland@yahoo.com
authors.forename: Shai
authors.initials: S
authors.lastname: Friedland
authors.forename: Daniel
authors.initials: D
authors.lastname: Sedehi
authors.forename: Roy
authors.initials: R
authors.lastname: Soetikno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin