Original ArticleA prospective control study of the safety and cellular yield of EUS-guided FNA or Trucut biopsy in patients taking aspirin, nonsteroidal anti-inflammatory drugs, or prophylactic low molecular weight heparin
Section snippets
Patients and methods
Consecutive patients undergoing EUS-FNA and/or TCB were studied prospectively for bleeding and other complications over an 18-month period. Patients' medications, in particular, aspirin, NSAIDs, and heparin/LMWH were recorded. Those receiving prophylactic doses of unfractionated heparin or LMWH were included in the study. EUS-FNA or TCB was contraindicated in patients taking warfarin or heparin/LMWH in therapeutic doses and they were managed in accordance with the ASGE guideline. Because of
Results
Two hundred fourteen consecutive patients underwent EUS-FNA or TCB over an 18-month period. Eight patients had a repeat procedure. TCB was performed on 31 patients, of whom 8 had procedures combined with FNA. The locations of the lesions were as follows: pancreas 151, intra-abdomen 55, mediastinum 34, and rectum 1. Eighteen patients had FNA performed on two separate lesions. There were 194 solid, 44 cystic or semi-cystic, and 3 ascitic cases.
The mean [SD] of the number of FNA passes was 2.2
Discussion
Studies have shown EUS-FNA or TCB to be a safe procedure with the rare occurrence of bleeding,2 pancreatitis,15, 16 or infection,17 as is also evident in this study. Our study also showed that EUS-FNA and/or TCB is/are safe in patients taking aspirin or NSAIDs, with respect to bleeding complications. This evidence concurs with and enhances the validity of the ASGE guideline.6 However, 2 of the 6 patients receiving prophylactic doses of LMWH in our study had bleeding events, although neither
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