title: Percutaneous endoscopic gastrostomy complication rates and compliance with the American Society for Gastrointestinal Endoscopy guidelines for the management of antithrombotic therapy.
abstract: BACKGROUND
  The American Society for Gastrointestinal Endoscopy (ASGE) has published recommendations in regards to anticoagulant (AC) and antiplatelet (AP) therapy management during endoscopic procedures. So far, no study has assessed either ASGE recommendation compliance during percutaneous endoscopic gastrostomy (PEG) placement or procedure-associated complication rates as related to the observance of these recommendations. The aims of this study were to compare the incidence and type of complications during PEG placement in patients receiving or not receiving AC and/or AP therapy and to determine the compliance with ASGE's AC and AP management guidelines.
  
  
  METHODS
  Medical files of patients who underwent PEG placement from January 2004 to December 2008 were reviewed. Clinical and procedure-related data were recorded. Patients were separated into 1 of 2 groups: patients under AP and/or AC therapy prior to PEG placement (n = 51) and a control group of patients (n = 40) not receiving any AP and/or AC treatment at least 6 months prior to the procedure.
  
  
  RESULTS
  A total of 91 patients (51 cases) were included. Groups were comparable in demographics and clinical characteristics. No differences in the frequency and type of complications were found between groups. ASGE's recommendations were not followed in any of these patients.
  
  
  CONCLUSIONS
  Overall PEG placement complication rate was 13.7%. AP therapy may be safely discontinued closer to the time of endoscopic procedure than the time currently recommended by the ASGE guidelines.
authors.affiliation: Advanced Endoscopy Unit, ABC Medical Center, México DF, México.
authors.forename: Diego
authors.initials: D
authors.lastname: Lozoya-González
authors.forename: Mario
authors.initials: M
authors.lastname: Pelaez-Luna
authors.forename: Alberto
authors.initials: A
authors.lastname: Farca-Belsaguy
authors.forename: Juan C
authors.initials: JC
authors.lastname: Salceda-Otero
authors.forename: Edgar
authors.initials: E
authors.lastname: Vazquéz-Ballesteros
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D019468:Disease Management; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects* / Q000379:methods; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors