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A frequent dilemma of endoscopists is balancing the elevated risk for postpolypectomy bleeding with that of cardiovascular thrombotic events in patients undergoing colonoscopy while on clopidogrel.
In a randomized, controlled, double-blind trial at an academic center in Hong Kong, investigators performed elective colonoscopy in 387 patients on clopidogrel. Patients stopped taking clopidogrel 7 days before colonoscopy, then were randomized to either clopidogrel 75 mg or placebo daily until the morning of colonoscopy, with resumption after the procedure. Concomitant aspirin was continued. Polypectomy technique was at the discretion of the endoscopist, but no prophylactic measures such as endoclips were permitted. All bleeding and cardiothrombo…