Gastrointestinal bleeding and the prevention of thromboembolism
Abstract
About 2 percent of developed countries population use vitamin K antagonists (VKA), such as warfarin.
These anticoagulation drugs are commonly prescribed for the purpose of thromboembolism prevention,
in cases of atrial fibrillation, mechanical heart valves, deep vein thrombosis, pulmonary embolism and
etc. The frequency of VKA prescription is massively increasing in the whole world. The main reason for
it is the ageing of the population. As the usage of anticoagulants is increasing, doctors more often get
to encounter patients with gastrointestinal bleeding taking anticoagulating drugs. The treatment of these
patients is difficult because there are several important factors that have to be considered while choosing
the tactic of treatment, such as the intensity of bleeding, coagulation, thrombotic risk and endoscopic
findings. Even if practical guidelines partially indicate the main principles of actions for similar cases, the
treatment of bleeding patients taking anticoagulants remains seriously challenging. This article contains
clinical case report and the discussion of the treatment that has been chosen in this case, based on
practical guidelines provided by American Society for Gastrointestinal Endoscopy (ASGE), European
Society of Gastrointestinal Endoscopy (ESGE) and European Society of Cardiology (ESC). This topic is
also addressed in guidelines from the American College of Gastroenterology, the American College of
Chest Physicians, the American College of Cardiology, which give similar recommendations.
Keywords: anticoagulantswarfarinbleedingthromboembolismanticoagulationendoscopy
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