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Anticoagulation is a well-recognized risk factor for postpolypectomy hemorrhage. The American Society for Gastrointestinal Endoscopy guidelines recommend that use of cold forceps is acceptable in patients who are therapeutically anticoagulated but note that polypectomy is a high-risk procedure for which reversal of anticoagulation should be considered. However, it seems reasonable to use cold forceps for the removal of tiny polyps in anticoagulated patients and to extend this concept to cold snaring, which is similar to cold forceps.
These authors compared bleeding risk after cold snare or conventional polypectomy in anticoagulated patients. They randomized 35 patients with 78 polyps to cold snare polypectomy and 35 patients with 81 polyps t…