Ultrasound-Guided Thoracenteses Can Be Done Safely Despite Continued Oral Anticoagulation or Antiplatelet Agents

A British guideline for thoracentesis recommends correction of bleeding risk factors, including the cessation of anticoagulants and antiplatelet agents, prior to the procedure (Thorax 2010; 65 Suppl 2: ii61). This guideline relies heavily on expert opinion and data that preceded the advent of ultrasound guidance for thoracentesis. Recent case series have shown minimal complications when patients with thrombocytopenia or mild coagulation abnormalities undergo thoracentesis; however, evidence regarding patients who were treated with antiplatelet agents or direct-acting oral anticoagulants (DOACs) is limited.

Investigators retrospectively studied 103 patients from a single Mayo Clinic institution who underwent 115 ultrasound-guided thoracentese…