Optimal timing of anticoagulation pre- and post-colonoscopy with polypectomy

Purpose An increasing number of patients are treated with anticoagulation for many medical conditions. Our practice is to suspend warfarin 5–7 days, aspirin 3 days, and clopidogrel (Plavix) 7 days prior to colonoscopy that may require polypectomy. Generally, we accept an INR of ≤1.5 as safe. However, there are no published case series documenting when it is safe to resume these medications after polypectomy. Therefore, the management of anticoagulation after polypectomy varies. We sought to evaluate the safety of our practice with regard to anticoagulation and polypectomy.