Management of Antithrombotics Around Gastrointestinal Procedures


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Release Date

5 Oct 2020

Expiration Date

27 Mar 2022

Last Reviewed

27 Mar 2021

Estimated Time To Finish

60 Minutes

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Activity Description

Antiplatelets and anticoagulants are used to reduce the risk of venous thromboembolism in patients at high risk. However, when these patients need gastrointestinal procedures like endoscopy, these agents increased the risk of bleeding related to the procedure. This activity reviews an interprofessional approach to holding antithrombotic therapy before different gastrointestinal procedures, and the resumption following the same.

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Target Audience

This activity has been designed to meet the educational needs of nurses.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify the risk of bleeding associated with different gastrointestinal procedures.
  • Summarize the risks of thromboembolism in different medical conditions.
  • Describe the approach to the management of anticoagulants and antiplatelets before elective gastrointestinal procedures.
  • Outline the approach to managing the risks of bleeding associated with antithrombotic agents in patients requiring emergent endoscopy by an interprofessional team.

Author(s) / Contributors Disclosure of Conflicts of Interest

Each author, editor, faculty and planning committee member have completed a disclosure form indicating that neither they nor their spouse/partner has a financial interest/arrangement or affiliation that could be perceived as a real or apparent conflict of interest related to the content of this activity.

COMMERCIAL SUPPORT: This activity has received NO commercial support.


Hover over the contributor names to see details and disclosures of any financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity.

Continuing Education Accreditation Information


This activity is jointly provided by AKH Inc., Advancing Knowledge in Healthcare and StatPearls. AKH, Inc., Advancing Knowledge in Healthcare is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. This activity is awarded 1.00 Contact Hours.

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  • StatPearls and AKH reserve the right to cancel any course due to unforeseen circumstances. StatPearls and AKH will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Equal Opportunity

  • StatPearls and AKH are Equal Opportunity / Affirmative Action / Equal Access Institutions. 

Medium or Media Used:

  • Computer Requirements:  Internet Access
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Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation form.
  7. Obtain a certificate.

StatPearls and AKH adhere to ANCC Standards regarding commercial support of continuing nursing education. It is the policy of StatPearls and AKH that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CNE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

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  • If you have concerns regarding CE, please contact or call AKH 877-AKH-CME4.


Media Usage Rights

The contributors and editors of StatPearls have attested that all associated media (images and video) have been legally cleared for use with this activity.  All copyrights are reserved.

  • Name: 'Table1.jpg' Attribution: Modified table from Acosta RD et al. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc 2016. CITED for the table, and also elsewhere in the text.
  • Name: 'Table2.jpg' Attribution: Modified table from Douketis JD. Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; CITED and acknowledged.
  • Name: 'Fig1.jpg' Attribution: Modified flow chart (not copied as such). CITED and acknowledged. From: Veitch AM et al. Endoscopy in patients on antiplatelet or anticoagulant therapy , including direct oral anticoagulants : British Society of Gastroenterology ( BSG ) and European Society of Gastrointestinal Endoscopy ( ESGE ) guidelines. 2016
  • Name: 'Fig2.jpg' Attribution: Modified flow chart (not copied). CITED for the figure and throughout the paper. Veitch AM et al. Endoscopy in patients on antiplatelet or anticoagulant therapy , including direct oral anticoagulants : British Society of Gastroenterology ( BSG ) and European Society of Gastrointestinal Endoscopy ( ESGE ) guidelines. 2016

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