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Colonoscopic polypectomy in patients on anticoagulation: time to embrace the cold revolution?
  1. Nicholas McDonald1,
  2. Saurabh Chandan2,
  3. Mohammad Bilal3
  1. 1Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
  2. 2Division of Gastroenterology and Hepatology, CHI Health Creighton University Medical Center, Omaha, Nebraska, USA
  3. 3Division of Gastroenterology and Hepatology, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Nicholas McDonald, Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, MN 55455, USA; mcdon620{at}

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We congratulate Lau et al1 on their manuscript looking at the risks of postcolonoscopic polypectomy bleeding and thromboembolism with warfarin and direct oral anticoagulants (DOAC). This is a territory-wide retrospective cohort study evaluating the safety of polypectomy during colonoscopy in patients taking DOACs or warfarin. The authors report relatively low rates of postpolypectomy bleeding (PPB) and thromboembolism and significantly lower rates in patients on apixaban compared with the other DOACs and warfarin. On a sensitivity analysis, authors reported right-sided polyp location, endoscopic resection method involving electrocautery, use of warfarin and advanced age as independent risk factors for PPB. Our comments attempt to clarify the effect of endoscopic resection technique …

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  • Twitter @NickMcDonaldMD, @BilalMohammadMD

  • Contributors NM, SC and MB were involved in drafting and editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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