title: EBUS-TBNA and EUS-FNA: Risk Assessment for Patients Receiving Clopidogrel.
abstract: BACKGROUND
  Clopidogrel is widely used for the prevention of thrombotic vascular complications. Its primary potential toxicity is bleeding. Management of clopidogrel therapy for patients undergoing invasive procedures is an area of ongoing study. We sought to evaluate the bleeding risk for patients undergoing needle aspiration biopsy by endobronchial ultrasound (EBUS) or esophageal ultrasound (EUS) while taking clopidogrel.
  
  
  METHODS
  Retrospective review of sequential cases of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and esophageal ultrasound fine needle aspiration (EUS-FNA).
  
  
  RESULTS
  Three hundred ninety-five consecutive procedures were reviewed. Thirty-seven patients were taking clopidogrel at time of biopsy. The patients taking clopidogrel were significantly older than those in the control group. Two patients (1%) in the control group were admitted for observation, but neither was found to have a significant bleed. There were no clinically significant bleeding complications in either of the study groups.
  
  
  CONCLUSIONS
  It is reasonable to proceed with EBUS-TBNA or EUS-FNA when both, (1) clopidogrel cannot be stopped and, (2) an important diagnostic question is at stake.
authors.affiliation: *Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR †Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, Cooper, Camden, NJ ‡Division of Pulmonary, Critical Care & Sleep Medicine, St. Louis University School of Medicine, St. Louis, MO.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Meena
authors.forename: Wissam
authors.initials: W
authors.lastname: Abouzgheib
authors.forename: Setu
authors.initials: S
authors.lastname: Patolia
authors.forename: Justin
authors.initials: J
authors.lastname: Rosenheck
authors.forename: Ziad
authors.initials: Z
authors.lastname: Boujaoude
authors.forename: Thaddeus
authors.initials: T
authors.lastname: Bartter
mesh_terms: D000367:Age Factors; D000368:Aged; D044963:Biopsy, Fine-Needle; D000077144:Clopidogrel; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D018570:Risk Assessment; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014463:Ultrasonography / Q000009:adverse effects
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine