Table 4

Risk assessment matrix of haemorrhagic and thrombotic risk

Risk of endoscopic procedure haemorrhageRisk of thrombosis
Low riskHigh riskLow riskHigh risk
 ContinueBiopsy 0%84Standard risk of procedure, except large colonic EMR 6.2–7%32 33 with ‘recent’ LDA.
Gastric ESD increased risk on LDA to 21.1%29 vs no increased risk 15.5%124
0.51% per year%2031.8% at 30 days36
 Discontinue 7 daysN/AStandard risk of procedureEstimate <1% per year9% at 30 days36
 ContinueBiopsy 0%84Polypectomy 0.8–23%6 7<1% per year2041% per year205
 Discontinue 5 daysN/AStandard risk of procedure; increased PPB risk15AF 0.4% at 30 days17N/A
 Bridge with LMWHN/AStandard risk of procedure; increased PPB risk15AF 0.3% at 30 days17Metal heart valves 0%22 23
Dual APA
 ContinueBiopsy 0%84 85Polypectomy <1 cm 2.1–6.45%120 121N/A1.3% at 9 months47
 5 days
N/AEstimate standard risk of procedureN/ANot advised
 Omit day of procedureNo specific dataN/ANo specific dataDOAC not indicated
 48 h
N/ANo specific data0.8%72DOAC not indicated
  • Key references in superscript.

  • AF, atrial fibrillation; APA, antiplatelet agent; DOAC, direct oral anticoagulant; EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; LDA, low-dose aspirin; LMWH, low molecular weight heparin; N/A, not applicable; PPB, post-polypectomy bleeding.