EBUS-TBNA and EUS-FNA Risk Assessment for Patients Receiving Clopidogrel
EBUS-TBNA and EUS-FNA Risk Assessment for Patients Receiving Clopidogrel
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DOI：
10.1097/lbr.0000000000000312
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发表时间：
2016-10-01
影响因子：
3.3
通讯作者：
Bartter, Thaddeus
中科院分区：
文献类型：
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作者：
Meena, Nikhil;Abouzgheib, Wissam;Bartter, Thaddeus
背景：氯吡格雷广泛用于预防血栓性血管并发症。它的主要潜在毒性是出血。对于接受侵入性操作的患者，氯吡格雷治疗的管理是一个正在进行的研究领域。我们试图评估出血风险的患者进行针吸活检，支气管内超声（EBUS）或食管超声（EUS），而服用clopidogreel.Methods：回顾性分析的连续情况下，支气管内超声引导下经支气管针吸（EBUS-TBNA）和食管超声细针穿刺（EUS-FNA）。37例患者在活检时正在服用氯吡格雷。服用氯吡格雷的患者年龄明显大于对照组。对照组中有2例患者（1%）入院观察，但均未发现明显出血。在任何一个研究groups.Conclusions：这是合理的进行EBUS-TBNA或EUS-FNA时，（1）氯吡格雷不能停止，（2）一个重要的诊断问题是危在旦夕。
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.