Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Effect of antithrombotic therapies on small bowel bleeding: an European multicenter retrospective study

  • Lucia Scaramella (Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Stefania Chetcuti Zammit (Gastroenterology Department, Mater Dei Hospital) ;
  • Reena Sidhu (Academic Dept of Gastroenterology, Royal Hallamshire Hospital) ;
  • Maurizio Vecchi (Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Gian Eugenio Tontini (Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Nicoletta Nandi (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Matilde Topa (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Luca Elli (Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)
  • Received : 2024.03.26
  • Accepted : 2024.07.01
  • Published : 2025.01.30
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Abstract

Background/Aims: Small bowel bleeding (SBB) is the main indication for videocapsule endoscopy (VCE); the diagnostic yield (DY) could be influenced by antithrombotic therapies. We explored the effects of these therapies on SBB. Methods: Consecutive patients from two centers (Milan, Italy and Sheffield, UK) who underwent VCE between March 2001 and July 2020 were considered. Demographic data, clinical parameters, drug therapy, and technical characteristics of the procedure were collected. VCE findings and DY were evaluated. Results: In total, 957 patients (1,052 VCEs) underwent VCE for SBB (DY 50.6%, no retention); 27 patients (27 VCEs) received direct oral anticoagulants, 87 (88 VCEs) received other anticoagulants, 115 (135 VCEs) received antiplatelet therapy, 198 (218 VCEs) received monotherapy, and 31 (32 VCEs) received combined therapy. There were no differences in the completion rate, findings, and DYs between each subgroup or between monotherapy and combined therapy. The overt bleeding rate was similar in all groups, even when comparing antithrombotic users versus those not on therapy (p=0.59) or monotherapy versus combined therapy (p=0.34). Conclusions: VCE is safe and has a high clinical impact on SBB. Antithrombotic therapies did not affect DY or overt bleeding rate and, consequently, can be considered safe in terms of SBB risk.

Keywords

Acknowledgement

This study was partially funded by the Italian Ministry of Health, Current Research IRCCS.

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