title: Endoscopic ultrasound-guided fine-needle aspiration of solid lesions on clopidogrel may not be a high-risk procedure for bleeding: A case series.
abstract: The major gastrointestinal endoscopy society guidelines list endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a high-risk procedure for bleeding. However, there are no studies evaluating the risk of bleeding for EUS-FNA of solid organs while patients continue to take clopidogrel. The aim of the present case series was to evaluate the rate of bleeding in a cohort of patients who underwent EUS-FNA for solid lesions while on clopidogrel. Bleeding was measured at the time of the procedure by bleeding seen on EUS, endoscopic visualization of blood, or drop in hemoglobin after the procedure. From 2013 to 2015, 10 patients were identified for this case series. Lesions that underwent EUS-FNA included gastric and rectal subepithelial lesions, pancreas masses, and liver masses. No immediate or delayed bleeding was observed in any of the patients. EUS-FNA of solid lesions on clopidogrel may not be a high-risk procedure for bleeding. Larger studies are needed to confirm this finding.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, USA.
authors.forename: Arvind J
authors.initials: AJ
authors.lastname: Trindade
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Hirten
authors.affiliation: Department of Preventive Medicine and Nutrition, Columbia University Medical Center, New York, USA.
authors.forename: Eoin
authors.initials: E
authors.lastname: Slattery
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, USA.
authors.forename: Sumant
authors.initials: S
authors.lastname: Inamdar
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, USA.
authors.forename: Divyesh V
authors.initials: DV
authors.lastname: Sejpal
mesh_terms: D000368:Aged; D000077144:Clopidogrel; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: anticoagulation; biopsy; bleeding; clopidogrel; endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA)