Management of Platelet-Directed Pharmacotherapy in Patients With Atherosclerotic Coronary Artery Disease Undergoing Elective Endoscopic Gastrointestinal Procedures

Journal of the American College of Cardiology

Volumn 54, Issue 24, 2009, Pages 2261-2276

  Becker, Richard C ^a   Scheiman, James ^b   Dauerman, Harold L ^c   Spencer, Frederick ^d   Rao, Sunil ^e   Sabatine, Marc ^f   Johnson, David A ^g   Chan, Frances ^h   Abraham, Neena S ⁱ   Quigley, Eamonn M M ^j  

^a DUKE UNIVERSITY MEDICAL CENTER   (United States)

^b UNIVERSITY OF MICHIGAN   (United States)

^c UNIVERSITY OF VERMONT   (United States)

^d MCMASTER UNIVERSITY   (Canada)

^e DURHAM VA MEDICAL CENTER   (United States)

^f BRIGHAM AND WOMEN S HOSPITAL   (United States)

^g Eastern Virginia School of Medicine   (United States)

^h CHINESE UNIVERSITY OF HONG KONG   (Hong Kong)

ⁱ BAYLOR COLLEGE OF MEDICINE   (United States)

^j UNIVERSITY COLLEGE CORK   (Ireland)

more..

Author keywords

coronary heart disease; periprocedural risk assessment; platelet antagonists

Indexed keywords

ACETYLSALICYLIC ACID; CANGRELOR; CILOSTAZOL; CLOPIDOGREL; FIBRINOGEN RECEPTOR ANTAGONIST; NARCOTIC AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; PRASUGREL; PROTON PUMP INHIBITOR; SODIUM DIHYDROGEN PHOSPHATE; THIENOPYRIDINE DERIVATIVE; TICAGRELOR; TICLOPIDINE; WARFARIN;

ACUTE CORONARY SYNDROME; ACUTE HEART INFARCTION; ASPIRATION BIOPSY; BRAIN HEMORRHAGE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CLINICAL TRIAL; COLONOSCOPY; CORONARY ARTERY ATHEROSCLEROSIS; DRUG ELUTING STENT; DRUG INDICATION; DRUG WITHDRAWAL; DUODENUM ULCER; ENDOSCOPIC ECHOGRAPHY; ENDOSCOPIC SCLEROTHERAPY; ENDOSCOPIC SPHINCTEROTOMY; ESOPHAGOGASTRODUODENOSCOPY; ESOPHAGUS DILATATION; FATALITY; GASTRIC BANDING; GASTROINTESTINAL BIOPSY; GASTROINTESTINAL ENDOSCOPY; GASTROINTESTINAL HEMORRHAGE; HEALING IMPAIRMENT; HEART INFARCTION; HUMAN; INTRAOCULAR HEMORRHAGE; ISCHEMIC HEART DISEASE; LASER SURGERY; LOADING DRUG DOSE; LOW DRUG DOSE; LUNG EMBOLISM; MEDICAL DECISION MAKING; NONHUMAN; PERCUTANEOUS CORONARY INTERVENTION; PHARMACODYNAMICS; PNEUMONIA; POINT OF CARE TESTING; POLYPECTOMY; PRACTICE GUIDELINE; PRIORITY JOURNAL; RECOMMENDED DRUG DOSE; REVIEW; RISK ASSESSMENT; ST SEGMENT ELEVATION; STENT THROMBOSIS; THROMBOCYTE ACTIVATION; THROMBOCYTE AGGREGATION; THROMBOCYTE FUNCTION; UNSTABLE ANGINA PECTORIS; UPPER GASTROINTESTINAL BLEEDING;

CORONARY ARTERY DISEASE; ENDOSCOPY, GASTROINTESTINAL; HEMORRHAGE; HUMANS; PLATELET AGGREGATION INHIBITORS; RISK ASSESSMENT; RISK FACTORS; STENTS; THROMBOSIS;

EID: 70649088108     PISSN: 07351097     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jacc.2009.09.012     Document Type: Review

References (97)

1. Mehta S., Yusuf S., Peters R., et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 358 (2001) 527-533
2. Lloyd-Jones D., Adams R., Carnethon M., et al. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 119 (2009) 480-486
3. Lloyd-Jones D.M., Larson M.G., Beiser A., et al. Lifetime risk of developing coronary heart disease. Lancet 353 (1999) 89-92
4. Ford E.S., Ajani U.A., Croft J.B., et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med 356 (2007) 2388-2398
5. Bhatt D.L., Scheiman J., Abraham N.S., et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 52 (2008) 1502-1517
6. Antman E.M., Hand M., Armstrong P.W., et al. 2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction). J Am Coll Cardiol 51 (2008) 210-247
7. Sabatine M.S., Cannon C.P., Gibson C.M., et al. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 352 (2005) 1179-1189
8. Chen Z.M., Jiang L.X., Chen Y.P., et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366 (2005) 1607-1621
9. Anderson J.L., Adams C.D., Antman E.M., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction). J Am Coll Cardiol 50 (2007) e1-e157
10. Yusuf S., Zhao F., Mehta S.R., et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345 (2001) 494-502
11. King III S.B., Smith Jr. S.C., Hirshfeld Jr. J.W., et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (2007 Writing Group to Review New Evidence and Update the 2005 ACC/AHA/SCAI Guideline Update for Percutaneous Coronary Intervention). J Am Coll Cardiol 51 (2008) 172-209
12. Fischman D.L., Leon M.B., Baim D.S., et al., Stent Restenosis Study Investigators. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 331 (1994) 496-501
13. Schomig A., Neumann F.J., Kastrati A., et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 334 (1996) 1084-1089
14. Serruys P.W., de Jaegere P., Kiemeneij F., et al., Benestent Study Group. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 331 (1994) 489-495
15. Leon M.B., Baim D.S., Popma J.J., et al., Stent Anticoagulation Restenosis Study Investigators. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. N Engl J Med 339 (1998) 1665-1671
16. Bhatt D.L., Bertrand M.E., Berger P.B., et al. Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stenting. J Am Coll Cardiol 39 (2002) 9-14
17. Bertrand M.E., Rupprecht H.J., Urban P., et al. Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting: the Clopidogrel Aspirin Stent International Cooperative Study (CLASSICS). Circulation 102 (2000) 624-629
18. Muller C., Buttner H.J., Petersen J., et al. A randomized comparison of clopidogrel and aspirin versus ticlopidine and aspirin after the placement of coronary-artery stents. Circulation 101 (2000) 590-593
19. Steinhubl S.R., Berger P.B., Mann III J.T., et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 288 (2002) 2411-2420
20. Bhatt D.L., Fox K.A., Hacke W., et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 354 (2006) 1706-1717
21. Ma L., Elliott S.N., Cirino G., et al. Platelets modulate gastric ulcer healing: role of endostatin and vascular endothelial growth factor release. Proc Natl Acad Sci U S A 98 (2001) 6470-6475
22. Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 343 (1994) 311-322
23. Chin M.W., Yong G., Bulsara M.K., et al. Predictive and protective factors associated with upper gastrointestinal bleeding after percutaneous coronary intervention: a case-control study. Am J Gastroenterol 102 (2007) 2411-2416
24. Gilard M., Arnaud B., Cornily J.C., et al. Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study. J Am Coll Cardiol 51 (2008) 256-260
25. Ho P.M., Maddox T.M., Wang L., et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. JAMA 301 (2009) 937-944
26. O'Donoghue M., Braunwald E., Antman E.M., et al. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton pump inhibitor. Lancet 374 (2009) 989-997
27. Wilson G.J., Nakazawa G., Schwartz R.S., et al. Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in porcine coronary arteries. Circulation 120 (2009) 141-149 1-2
28. Mauri L., Hsieh W.H., Massaro J.M., et al. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med 356 (2007) 1020-1029
29. van Werkum J.W., Heestermans A.A., de Korte F.I., et al. Long-term clinical outcome after a first angiographically confirmed coronary stent thrombosis: an analysis of 431 cases. Circulation 119 (2009) 828-834
30. Cutlip D.E., Baim D.S., Ho K.K., et al. Stent thrombosis in the modern era: a pooled analysis of multicenter coronary stent clinical trials. Circulation 103 (2001) 1967-1971
31. Iakovou I., Schmidt T., Bonizzoni E., et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 293 (2005) 2126-2130
32. Aoki J., Lansky A.J., Mehran R., et al. Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation 119 (2009) 687-698
33. Mega J.L., Close S.L., Wiviott S.D., et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med 360 (2009) 354-362
34. Sianos G., Papafaklis M.I., Daemen J., et al. Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burden. J Am Coll Cardiol 50 (2007) 573-583
35. Ferrari E., Benhamou M., Cerboni P., et al. Coronary syndromes following aspirin withdrawal: a special risk for late stent thrombosis. J Am Coll Cardiol 45 (2005) 456-459
36. Collet J.P., Montalescot G., Blanchet B., et al. Impact of prior use or recent withdrawal of oral antiplatelet agents on acute coronary syndromes. Circulation 110 (2004) 2361-2367
37. Schouten O., van Domburg R.T., Bax J.J., et al. Noncardiac surgery after coronary stenting: early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events. J Am Coll Cardiol 49 (2007) 122-124
38. Wilson S.H., Fasseas P., Orford J.L., et al. Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting. J Am Coll Cardiol 42 (2003) 234-240
39. Kaluza G.L., Joseph J., Lee J.R., et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 35 (2000) 1288-1294
40. Grines C.L., Bonow R.O., Casey Jr. D.E., et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol 49 (2007) 734-739
41. Finn A.V., Joner M., Nakazawa G., et al. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 115 (2007) 2435-2441
42. Eisenstein E.L., Anstrom K.J., Kong D.F., et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA 297 (2007) 159-168
43. Airoldi F., Colombo A., Morici N., et al. Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment. Circulation 116 (2007) 745-754
44. Kimura T., Morimoto T., Nakagawa Y., et al. Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation. Circulation 119 (2009) 987-995
45. Eisenberg M.J., Richard P.R., Libersan D., et al. Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents. Circulation 119 (2009) 1634-1642
46. Santilli F., Rocca B., De Cristofaro R., et al. Platelet cyclooxygenase inhibition by low-dose aspirin is not reflected consistently by platelet function assays: implications for aspirin "resistance.". J Am Coll Cardiol 53 (2009) 667-677
47. Taggart D.P., Siddiqui A., and Wheatley D.J. Low-dose preoperative aspirin therapy, postoperative blood loss, and transfusion requirements. Ann Thorac Surg 50 (1990) 424-428
48. Wallentin L., Becker R.C., Budaj A., et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 361 (2009) 1045-1057
49. Vicenzi M.N., Meislitzer T., Heitzinger B., et al. Coronary artery stenting and non-cardiac surgery-a prospective outcome study. Br J Anaesth 96 (2006) 686-693
50. Broad L., Lee T., Conroy M., et al. Successful management of patients with a drug-eluting coronary stent presenting for elective, non-cardiac surgery. Br J Anaesth 98 (2007) 19-22
51. Patti G., Colonna G., Pasceri V., et al. Randomized trial of high loading dose of clopidogrel for reduction of periprocedural myocardial infarction in patients undergoing coronary intervention: results from the ARMYDA-2 (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty) study. Circulation 111 (2005) 2099-2106
52. Gurbel P.A., Becker R.C., Mann K.G., et al. Platelet function monitoring in patients with coronary artery disease. J Am Coll Cardiol 50 (2007) 1822-1834
53. Price M.J., Berger P.B., Angiolillo D.J., et al. Evaluation of individualized clopidogrel therapy after drug-eluting stent implantation in patients with high residual platelet reactivity: design and rationale of the GRAVITAS trial. Am Heart J 157 (2009) 818-824 824.e1
54. Arrowsmith J.B., Gerstman B.B., Fleischer D.E., et al. Results from the American Society for Gastrointestinal Endoscopy/U.S. Food and Drug Administration collaborative study on complication rates and drug use during gastrointestinal endoscopy. Gastrointest Endosc 37 (1991) 421-427
55. Quine M.A., Bell G.D., McCloy R.F., Charlton J.E., Devlin H.B., and Hopkins A. Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods. Gut 36 (1995) 462-467
56. Rogers B.H., Silvis S.E., Nebel O.T., et al. Complications of flexible fiberoptic colonoscopy and polypectomy. Gastrointest Endosc 22 (1975) 73-77
57. Alam M., Schuman B.M., Duvernoy W.F., et al. Continuous electrocardiographic monitoring during colonoscopy. Gastrointest Endosc 22 (1976) 203-205
58. Fletcher G.F., Earnest D.L., Shuford W.F., et al. Electrocardiographic changes during routine sigmoidoscopy. Arch Intern Med 122 (1968) 483-486
59. Fujita R., and Kumura F. Arrythmias and ischemic changes of the heart induced by gastric endoscopic procedures. Am J Gasteroenterol 64 (1975) 44-48
60. Mathew P.K., Ona F.V., Damevski K., et al. Arrhythmias during upper gastrointestinal endoscopy. Angiology 30 (1979) 834-840
61. Marsh W.H., Bronner M.H., Yantis P.L., et al. Ventricular ectopy associated with peroral colonic lavage. Gastrointest Endosc 32 (1986) 259-263
62. Tezuka K., Nomura M., Saito K., et al. Changes in autonomic nervous activity during colonoscopy using spectral analysis of heart rate variability. Digestive Endoscopy 12 (2000) 155-161
63. Cappell M.S., and Abdullah M. Management of gastrointestinal bleeding induced by gastrointestinal endoscopy. Gastroenterol Clin North Am 29 (2000) 125-167 vi-vii
64. Veitch A.M., Baglin T.P., Gershlick A.H., et al. Guidelines for the management of anticoagulant and antiplatelet therapy in patients undergoing endoscopic procedures. Gut 57 (2008) 1322-1329
65. Rabeneck L., Paszat L.F., Hilsden R.J., et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology 135 (2008) 1899-1906 1906.e1
66. Watabe H., Yamaji Y., Okamoto M., et al. Risk assessment for delayed hemorrhagic complication of colonic polypectomy: polyp-related factors and patient-related factors. Gastrointest Endosc 64 (2006) 73-78
67. Singaram C., Torbey C.F., and Jacoby R.F. Delayed postpolypectomy bleeding. Am J Gasteroenterol 90 (1995) 146-147
68. Nelson D.B., McQuaid K.R., Bond J.H., et al. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc 55 (2002) 307-314
69. Sorbi D., Norton I., Conio M., et al. Postpolypectomy lower GI bleeding: descriptive analysis. Gastrointest Endosc 51 (2000) 690-696
70. Sawhney M.S., Salfiti N., Nelson D.B., et al. Risk factors for severe delayed postpolypectomy bleeding. Endoscopy 40 (2008) 115-119
71. Tolliver K.A., and Rex D.K. Colonoscopic polypectomy. Gastroenterol Clin North Am 37 (2008) 229-251
72. Horiuchi A., Nakayama Y., Tanaka N., et al. Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomy. Endoscopy 40 (2008) 722-726
73. Williams E.J., Taylor S., Fairclough P., et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy 39 (2007) 793-801
74. ASGE Technology Committee, Kantsevoy S.V., Adler D.G., et al. Endoscopic mucosal resection and endoscopic submucosal dissection. Gastrointest Endosc 68 (2008) 11-18
75. Hui A.J., Wong R.M.Y., Ching J.Y.L., et al. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointest Endosc 59 (2004) 44-48
76. Shiffman M.L., Farrel M.T., and Yee Y.S. Risk of bleeding after endoscopic biopsy or polypectomy in patients taking aspirin or other NSAIDS. Gastrointest Endosc 40 (1994) 458-462
77. Yousfi M., Gostout C.J., Baron T.H., et al. Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. Am J Gasteroenterol 99 (2004) 1785-1789
78. Hussain N., Alsulaiman R., Burtin P., et al. The safety of endoscopic sphincterotomy in patients receiving antiplatelet agents: a case-control study. Aliment Pharmacol Ther 25 (2007) 579-584
79. Hui C.K., Lai K.C., Yuen M.F., et al. Does withholding aspirin for one week reduce the risk of post-sphincterotomy bleeding?. Aliment Pharmacol Ther 16 (2002) 929-936
80. Sharis P., Cannon C., and Loscalzo J. The antiplatelet effects of ticlopidine and clopidogrel. Ann Intern Med 129 (1998) 394-405
81. Patrono C., Coller B., FitzGerald G.A., Hirsh J., and Roth G. Platelet-active drugs: the relationships among dose, effectiveness, and side effects: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126 Suppl (2004) 234S-264S
82. Fork F.T., Lafolie P., Toth E., et al. Gastroduodenal tolerance of 75 mg clopidogrel versus 325 mg aspirin in healthy volunteers. A gastroscopic study. Scand J Gastroenterol 35 (2000) 464-469
83. Ernst A., Eberhardt R., Wahidi M., et al. Effect of routine clopidogrel use on bleeding complications after transbronchial biopsy in humans. Chest 129 (2006) 734-737
84. Zuckerman M.J., Hirota W.K., Adler D.G., et al. ASGE guideline: the management of low-molecular-weight heparin and nonaspirin antiplatelet agents for endoscopic procedures. Gastrointest Endosc 61 (2005) 189-194
85. Diener H., Bogousslavsky J., and Brass L.M. Aspirin and clopidogrel compared with clopidogrel alone after recent ischemic stroke or transient ischaemic attack in high-risk patients (MATCH) randomised, double-blind, placebo-controlled trial. Lancet 364 (2004) 331-337
86. Buresly K., Eisenberg M., Zhang X., et al. Bleeding complications associated with combinations of aspirin, hienopyridine derivatives, and warfarin in elderly patients following acute myocardial infarction. Arch Intern Med 165 (2005) 784-789
87. Ono S., Fujishiro M., Niimi K., et al. Technical feasibility of endoscopic submucosal dissection for early gastric cancer in patients taking anti-coagulants or anti-platelet agents. Dig Liver Dis 41 (2009) 725-728
88. Uedo N., Takeuchi Y., Yamada T., et al. Effect of a proton pump inhibitor or an H2-receptor antagonist on prevention of bleeding from ulcer after endoscopic submucosal dissection of early gastric cancer: a prospective randomized controlled trial. Am J Gasteroenterol 102 (2007) 1610-1616
89. Shioji K., Suzuki Y., Kobayashi M., et al. Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy. Gastrointest Endosc 57 (2003) 691-694
90. Friedland S., and Soetikno R. Colonoscopy with polypectomy in anticoagulated patients. Gastrointest Endosc 64 (2006) 98-100
91. Howell D.A., Loew B.J., Sanders M.K., et al. Use of hemostatic clips in patients undergoing colonoscopy in the setting of coumadin antithrombotic therapy. Gastrointest Endosc 63 (2006) AB99
92. Di Giorgio P., De Luca L., Calcagno G., et al. Detachable snare versus epinephrine injection in the prevention of postpolypectomy bleeding: a randomized and controlled study. Endoscopy 36 (2004) 860-863
93. Iishi H., Tatsuta M., Narahara H., et al. Endoscopic resection of large pedunculated colorectal polyps using a detachable snare. Gastrointest Endosc 44 (1996) 594-597
94. Paspatis G.A., Paraskeva K., Theodoropoulou A., et al. A prospective, randomized comparison of adrenaline injection in combination with detachable snare versus adrenaline injection alone in the prevention of postpolypectomy bleeding in large colonic polyps. Am J Gastroenterol 101 (2006) 2805 quiz 2913
95. Sung J.Y., Chung S.C., Low J.M., et al. Systemic absorption of epinephrine after endoscopic submucosal injection in patients with bleeding peptic ulcers. Gastrointest Endosc 39 (1993) 20-22
96. Sung J., Ching J., et al. Can aspirin be reintroduced with PPI inhibitor infusion after endoscopic hemostasis: a double-blind randomized controlled trial. LJ. Gastroenterology 130 (2008) A44
97. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348 (1996) 1329-1339