title: Effect of routine clopidogrel use on bleeding complications after ultrasound-guided thoracentesis.
abstract: BACKGROUND
  Thoracentesis is one of the most commonly performed medical procedures with an excellent safety profile. Clopidogrel (a compound that inhibits adenosine diphosphate-induced platelet aggregation) is often prescribed for primary or secondary prevention of cardiovascular disease and has been associated with bleeding complications in patients undergoing surgical procedures. The purpose of this study was to assess the safety of ultrasound (US)-guided thoracentesis in patients receiving clopidogrel therapy.
  
  
  METHODS
  Data were collected on 30 consecutive patients taking clopidogrel without other known underlying coagulation problems. These patients underwent 45 US-guided thoracenteses over 26 months. Clopidogrel was not discontinued before the thoracentesis in patients presenting with symptomatic pleural effusion. Thoracenteses were performed in these patients and the incidence of bleeding and other complications among patients was reported.
  
  
  RESULTS
  Between June 2009 and August 2011, there were 30 consecutive patients on clopidogrel at the time of thoracenteses. These patients presented with respiratory distress because of pleural effusion and underwent a total of 45 thoracenteses. There was no significant bleeding or other complications in this patient population. No patient required transfusion after the procedure.
  
  
  CONCLUSIONS
  Patients who are receiving clopidogrel and present with symptomatic pleural effusion can safely undergo US-guided thoracentesis without interrupting clopidogrel before the procedure. Larger studies are required to confirm these results.
authors.affiliation: Emory University School of Medicine, Atlanta, GA 30322, USA. mohammad.b.zalt@emory.edu
authors.forename: Mohammad B
authors.initials: MB
authors.lastname: Zalt
authors.forename: Rabih I
authors.initials: RI
authors.lastname: Bechara
authors.forename: Christopher
authors.initials: C
authors.lastname: Parks
authors.forename: David M
authors.initials: DM
authors.lastname: Berkowitz
mesh_terms: D000077144:Clopidogrel; D000075202:Contraindications; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors; D010996:Pleural Effusion / Q000601:surgery*; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000601:surgery; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D013988:Ticlopidine / Q000031:analogs & derivatives*; D018084:Ultrasonography, Interventional
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine