Cold Snare Best Polyp Remover if Blood Thinners Involved 2013 - Waleed Mahrous
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Cold Snare Best Polyp Remover if Blood Thinners Involved 2013 - Waleed Mahrous

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Cold snare polypectomy outperformed conventional polypectomy for the removal of small colon polyps in patients receiving anticoagulation therapy ...

Cold snare polypectomy outperformed conventional polypectomy for the removal of small colon polyps in patients receiving anticoagulation therapy
Cold snare is a polyp removal technique using a metal snare wire to catch and remove a polyp without electrocautery.

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    Cold Snare Best Polyp Remover if Blood Thinners Involved 2013 - Waleed Mahrous Cold Snare Best Polyp Remover if Blood Thinners Involved 2013 - Waleed Mahrous Presentation Transcript

    • Waleed Kh. Mahrous Dr Waleed Kh. Mahrous
    • Waleed Kh. Mahrous  Cold snare polypectomy outperformed conventional polypectomy for the removal of small colon polyps in patients receiving anticoagulation therapy  Cold snare is a polyp removal technique using a metal snare wire to catch and remove a polyp without electrocautery.  Cold snare polypectomy retrieved polyps of the same size, number, and shape in significantly shorter time than conventional polypectomy (16 minutes versus 26 minutes, P<0.0001 Dr Waleed Kh. Mahrous http://www.medpagetoday.com/MeetingCoverage/DDW/39335
    • Waleed Kh. Mahrous  Cold snare polyp retrieval was also significantly associated with less immediate bleeding (5.7% versus 23%, P=0.04) and no delayed bleeding (P=0.02)  Current practice guidelines for colonoscopy identify polypectomy as a high-risk procedure in patients receiving anticoagulation therapy due to increased bleeding risks, and recommend those receiving treatment to temporarily discontinue use of anticoagulant agents..  "I think we need to re-evaluate our tradition of discontinuing warfarin before the procedure Dr Waleed Kh. Mahrous http://www.medpagetoday.com/MeetingCoverage/DDW/39335
    • Waleed Kh. Mahrous  Speculated that delayed bleeds would be due to blood vessel injury in the submucosa layer from electrocautery used in conventional polypectomy.  The authors evaluated risk of postprocedure bleeding in 70 patients randomized to receive cold snare or traditional endoscopic polypectomy to remove colorectal polyps up to 10 mm in diameter. Participants were receiving warfarin and were told to not discontinue therapy prior to treatment. http://www.medpagetoday.com/MeetingCoverage/DDW/39335
    • Waleed Kh. Mahrous  Outcomes included immediate bleeds following the procedure, delayed bleeding, time to complete removal of all polyps in a patient, and thromboembolic event incidence.  Although cold snare had significantly better outcomes for immediate bleeding, the odds ratio did not reach statistical significance  The authors reported. However, no delayed bleeding occurred in the cold snare group whereas 14% of patients in the conventional group required endoscopic hemostasis. Dr Waleed Kh. Mahrous http://www.medpagetoday.com/MeetingCoverage/DDW/39335 http://www.medpagetoday.com/MeetingCoverage/DDW/39335
    • Waleed Kh. Mahrous  Thromboembolic events were not reported in either group. Dr Waleed Kh. Mahrous http://www.medpagetoday.com/MeetingCoverage/DDW/39335