Hemorrhage Following Small Polyp Resection in the Colon in Anticoagulated Patients
Status:
Unknown status
Trial end date:
2017-07-01
Target enrollment:
Participant gender:
Summary
One of the well-known of complications post colonic polypectomy is bleeding usually occuring
in the 2-week period following the procedure. Patients treated with oral anticoagulation
(e.g. Warfarin) are a special and challenging patient group due to the need on the one hand
to prevent thromboembolic events, and on the second hand to minimize the risk of
post-polypectomy bleeding. Current practice guidelines recommend holding Warfarin treatment
while bridging with LMW Heparin while resuming Warfarin treatment following the procedure.
This practice was found to be associated with a much higher rate of bleeding compared with
continuing Warfarin in a recent prospective trial in pacemaker transplanted patients. The
fact that most post-polypectomy bleeding occurs within the 2-week period further questions
the current practice of periprocedural bridging therapy. the investigators therefore
hypothesize that patients with continuous Warfarin treatment may have similar
post-polypectomy bleeding rates compared to patients receiving bridging therapy with LMW
Heparin.
This is a multicenter single-blinded prospective randomized trial comparing small
post-polypectomy (polyps<10mm) bleeding rates between two groups of patients: Continuous
therapy with Warfarin, vs. LMW Heparin therapy while withholding Warfarin therapy (current
practice).
Phase:
N/A
Details
Lead Sponsor:
Hadassah Medical Organization
Collaborators:
Carmel Medical Center Rambam Health Care Campus Soroka University Medical Center Tel Aviv Medical Center