Barrett's Esophagus: Drugs Key to Less Resection Bleeding

Raised lesions of dysplastic Barrett's esophagus (BE) are treated with endoscopic mucosal resection (EMR) before ablation. But the procedure causes bleeding in 10% of cases. Reporting at the American College of Gastroenterology Annual Scientific Meeting in Honolulu Oct. 16 to Oct. 21, Mayo Clinic researchers said they found a way to reduce those adverse events.

Daniel Chan, MD and colleagues in Rochester, MN said their practice of withholding antiplatelet agents for 5 days prior to EMR and maintaining an INR of less than 1.5 was associated with an overall bleeding rate of only 1.3%.

They also routinely put high-risk patients who are taking warfarin on a bridge therapy of low molecular weight heparin.

The team reviewed 3,114 EMR sessions involving 1,312 patients.

Only 41 had EMR bleeding.

The highest risk was seen in patients who got combination blood thinner therapy.

They also saw more bleeding in patients who took aspirin and clopidogrel.