Use and cost-effectiveness of prophylactic clips following colonoscopic polypectomy.

AG According to retrospective data in the literature, the risk of bleeding after colonoscopic polypectomy ranges from 0.2% to 1.2% in patients without risk factors for bleeding. When patients are on blood thinners, such as aspirin or warfarin, this risk has been reported to be as high as 6.8% in some studies. However, these estimates come from variable study designs and patient populations, which is why, in a recent study, my colleagues and I estimated the range to be 2.5% to 3.4% in patients who are on aspirin or anticoagulants. The risk of postpolypectomy bleeding also depends on other factors, such as removal of large (>1 cm) and/or multiple polyps, a very large defect, and nonsteroidal antiinflammatory drug use, such as use of ibuprofen. One of the prophylactic methods commonly used by physicians is risk-stratifying patients, particularly in terms of anticoagulant therapy (ie, determining whether patients really need to be on anticoagulant therapy during the procedure and stopping therapy whenever possible).