HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

Electronic Letters to:

INTERVENTIONAL PULMONOLOGY: Armin Ernst, Ralf Eberhardt, Momen Wahidi, Heinrich D. Becker, and Felix J. F. Herth Effect of Routine Clopidogrel Use on Bleeding Complications After Transbronchial Biopsy in Humans Chest 2006; 129: 734-737 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Continuation of clopidogrel may be safe during bronchoscopy with biopsy?!

Emmanouil S. Brilakis, Subhash Banerjee   (16 September 2006)

Continuation of clopidogrel may be safe during bronchoscopy with biopsy?! 16 September 2006
Emmanouil S. Brilakis, Director, Cardiac Catheterization Laboratory Dallas VA Medical Center, Subhash Banerjee Send letter to journal: Re: Continuation of clopidogrel may be safe during bronchoscopy with biopsy?! emmanouil.brilakis{at}utsouthwestern.edu Emmanouil S. Brilakis, et al.	We read with great interest the well performed and timely study by Ernst et al " Effect of Routine Clopidogrel Use on Bleeding Complications After Transbronchial Biopsy in Humans" Chest 2006; 129: 734-737. With the expanding use of drug-eluting coronary stents that may be at risk for thrombosis even years after implantation, continuation of antiplatelet therapy with aspirin and/or clopidogrel is becoming increasingly important to prevent this highly morbid complication. The risk of stent thrombosis increases during and after invasive procedures, such as bronchoscopy. Continuation of antiplatelet therapy during the periprocedural period could significantly decrease the risk of stent thrombosis. Yet, operators very often choose to discontinue antiplatelet therapy due to a valid concern for bleeding. In the current study, even though patients on clopidogrel had greatly increased risk of bleeding after transbronchial lung biopsy, there were no adverse clinical outcomes, since "Bleeding responded to topical endoscopic treatment, and no patients required intubation or admission to critical care areas. No patients required blood transfusion". Therefore, might an alternative interpretation of the study's findings be: "Continuation of clopidogrel during bronchoscopy with biopsy appears to be safe (no significant increase in the need for transfusions, hospitalization, or death), apart from requiring additional endoscopic treatment. Continuation of clopidogrel during bronchoscopy with biopsy should therefore be considered as a viable option in patients who may at risk of catastrophic complications after clopidogrel discontinuation, such as patients with prior (especially recent and drug-eluting) coronary stent implantation"?!