Cold Snare Best Polyp Remover if Blood Thinners Involved 2013 - Waleed Mahrous

Waleed Kh. Mahrous

Cold Snare Best Polyp Remover if Blood Thinners

Involved

Dr Waleed Kh. Mahrous

Cold snare polypectomy outperformed conventional polypectomy for the removal of small colon polyps in patients receiving anticoagulation therapy

Cold snare is a polyp removal technique using a metal snare wire to catch and remove a polyp without electrocautery.

Cold snare polypectomy retrieved polyps of the same size, number, and shape in significantly shorter time than conventional polypectomy (16 minutes versus 26 minutes, P<0.0001 http://www.medpagetoday.com/MeetingCoverage/DDW/39335

Waleed Kh. Mahrous

Cold Snare Best Polyp Remover if Blood Thinners Involved

Dr Waleed Kh. Mahrous

Cold snare polyp retrieval was also significantly associated with less immediate bleeding (5.7% versus 23%, P=0.04) and no delayed bleeding (P=0.02)

Current practice guidelines for colonoscopy identify polypectomy as a high-risk procedure in patients receiving anticoagulation therapy due to increased bleeding risks, and recommend those receiving treatment to temporarily discontinue use of anticoagulant agents..

"I think we need to re-evaluate our tradition of discontinuing warfarin before the procedure

Cold Snare Best Polyp Remover if Blood Thinners Involved

Waleed Kh. Mahrous

http://www.medpagetoday.com/MeetingCoverage/DDW/39335Dr Waleed Kh. Mahrous

Speculated that delayed bleeds would be due to blood vessel injury in the submucosa layer from electrocautery used in conventional polypectomy.

The authors evaluated risk of postprocedure bleeding in 70 patients randomized to receive cold snare or traditional endoscopic polypectomy to remove colorectal polyps up to 10 mm in diameter. Participants were receiving warfarin and were told to not discontinue therapy prior to treatment.

Cold Snare Best Polyp Remover if Blood Thinners Involved

Waleed Kh. Mahrous

http://www.medpagetoday.com/MeetingCoverage/DDW/39335

Outcomes included immediate bleeds following the procedure, delayed bleeding, time to complete removal of all polyps in a patient, and thromboembolic event incidence.

Although cold snare had significantly better outcomes for immediate bleeding, the odds ratio did not reach statistical significance

The authors reported. However, no delayed bleeding occurred in the cold snare group whereas 14% of patients in the conventional group required endoscopic hemostasis.

Cold Snare Best Polyp Remover if Blood Thinners Involved

Waleed Kh. Mahrous

http://www.medpagetoday.com/MeetingCoverage/DDW/39335http://www.medpagetoday.com/MeetingCoverage/DDW/39335

Dr Waleed Kh. Mahrous

Thromboembolic events were not reported in either group.

Cold Snare Best Polyp Remover if Blood Thinners Involved

Waleed Kh. Mahrous

http://www.medpagetoday.com/MeetingCoverage/DDW/39335Dr Waleed Kh. Mahrous