Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 51

In case of chronic blood loss and a recently placed stent, dual antiplatelet therapy should probably be continued as mandated, and, if indicated, endoscopic intervention performed while the patient is on dual antiplatelet therapy. PPI is administered and testing for H. pylori performed.¹⁵⁰

In case of a major GI bleed, the cessation of one antiplatelet agent may be judged necessary, mainly when DES is >1 month old. Following successful endoscopic therapy of upper GI bleed combined with high-dose PPI therapy, it may be reasonable to reintroduce antiplatelet therapy 3–7 days later in those who remain free of recurrent bleeding. In case of lower GI bleed, one may delay antiplatelet therapy for 7–10 days, depending on the colonic lesion size and the adequacy of endoscopic treatment.¹¹¹