?? ????? ?? ??? ??? 4~5 ??? ??.
????? ?? ???: ?<????<??<?? ??
????? ?????? ??: ??? ?? ??. ???- ??. ??? ?? ??. ??? ??(???, ??? ?????????)
?? ?? ????
| Risk | Class | Name | Duration |
| ??? | ???? | ??? heparin | 4? |
| ??? warfarin | 4? | ||
| ????? | ???? | 5-7? | |
| ?????? clopidogrel | 7? | ||
| ????? ticlopidine | 10-14? | ||
| ????? cilostazol | 4? | ||
| ???? sarpogrelate | 1? | ||
| ????? triflusal | 5? | ||
| ????? mesoglycan | 3-4? | ||
| ????? sulodexide | 4? | ||
| DOAC | >48hr | ||
| ????? | ?????? beraprost | 1? | |
| ?????? limaprost | 1? | ||
| ????? | ????? nicergoline | 1? | |
| ????? Ginkgo biloba | 1.5? | ||
| ?????? ibudilast | 3? | ||
| ????? nootropics | ???? piracetam | 7? | |
| ??? ??? | ??? 4?~ ??? 2? | ||
| ??? | NSAIDs | ?????? 1? ????? 2-3? ???? 1? ????? 1? ???? 2-3? ???? 1? ???? 1? ?????? 1? ??????? 1? ???? 2-3? ???? 4-7? ???? 7? ??? 4? ????? 2-3? | |
| Statin | ?????? rosuva- | ?? 4-5? | |
| Lactic acidosis | Metformin | ?? 48hr | |
| ONJ | Bisphosphonate | Low-risk, 4? ?? ?? | ?? x |
| Otherwise | 2-3?? |
??? ?? ????
| Risk | Procedures | |
| Low-risk procedure | Diagnostic procedure +/- biopsy Biliary or pancreatic stenting Diagnostic EUS Device-assisted enteroscopy w/o polypectomy | P2Y12i: continue Warfarin: continue, check INR before endoscopy. within therapeutic range -> continue usual dose above therapeutic range, But <5 -> reduce dose until INR returns to normal. DOAC: omit on morning of procedure |
| High-risk procedure | Polypectomy ERCP with sphincterotomy Ampullectomy EMR/ESD Dilation of strictures Therapy of varices PEG EUS with FNA Oesphageal, enteral or colonic stenting | (Follow the table below) |
| Class | Risk | Example | Guideline |
| P2Y12i | Low-risk condition | Ischemic heart disease without coronary stent Cerebrovascular disease Peripheral vascular disease | Stop 5 days before endoscopy. Continue aspirin if already prescribed. |
| High-risk condition | Coronary artery stents | Consider stop 5 days before endoscopy if… 12 months after insertion of DES. 1 month after insertion of BMS. Continue aspirin. | |
| Warfarin | Low-risk condition | Prosthetic metal heart valve in aortic position. Xenograft heart favle. AF without valvular disease > 3months after VTE. Thrombophilia syndromes. | |
| High-risk condition | Prosthetic metal heart valve in mitral position. Prosthetic heart valve and AF. AF and mitral stenosis. <3months after VTE. | Stop 5 days before endoscopy Start LMWH 2days after stopping warfarin. Give last dose of LMWH >24hrs before procedure. Restart warfarin evening of procedure with usual daily dose. Continue LMWH until INR adequate. |
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