{"id":19015,"date":"2025-06-14T14:11:12","date_gmt":"2025-06-14T14:11:12","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/es\/?p=19015"},"modified":"2025-06-14T14:12:28","modified_gmt":"2025-06-14T14:12:28","slug":"antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/","title":{"rendered":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda"},"content":{"rendered":"<p>El t\u00e9rmino antitromb\u00f3tico compila los f\u00e1rmacos que poseen efecto <strong>antiagregante plaquetario<\/strong> o <strong>anticoagulante<\/strong>. Muchos pacientes han estado usando estas medicaciones continuas en situaciones cl\u00ednicas como fibrilaci\u00f3n auricular, implante de v\u00e1lvulas mec\u00e1nicas, trombosis venosa profunda y tromboembolismo pulmonar.<\/p>\n<p>Con el objetivo de reducir los riesgos y un uso adecuado de los f\u00e1rmacos antitromb\u00f3ticos periprocedimientos, incluyendo aquellos con abordajes endosc\u00f3picos, se hace necesario un adecuado entendimiento de los procesos de hemostasia, de los mecanismos de acci\u00f3n de estas medicaciones, sus indicaciones de uso, farmacocin\u00e9tica y abordaje en caso de sangrado. Para tal, las conductas citadas estar\u00e1n basadas en los Guidelines de la American Society for Gastrointestinal Endoscopy (ASGE) y European Society of Gastrointestinal Endoscopy (ESGE) [1,2].<\/p>\n<h2 class=\"wp-block-heading\"><strong><u>Mecanismos de Coagulaci\u00f3n<\/u><\/strong><\/h2>\n<p>La hemostasia primaria es el proceso inicial de la coagulaci\u00f3n desencadenado por la lesi\u00f3n vascular. Inmediatamente, mecanismos locales producen vasoconstricci\u00f3n, alteraci\u00f3n de la permeabilidad vascular con producci\u00f3n de edema, vasodilataci\u00f3n de los vasos tributarios de la regi\u00f3n en que ocurri\u00f3 la lesi\u00f3n y adhesi\u00f3n de las plaquetas. El endotelio del vaso lesionado libera difosfato de adenosina, serotonina y tromboxano A2. Las plaquetas responden a estas citoquinas con la expresi\u00f3n de glicoprote\u00edna IIb\/IIIa y junto a la mol\u00e9cula de adhesi\u00f3n celular plaqueta endotelio tipo 1 llevan a la formaci\u00f3n de un tap\u00f3n plaquetario inicial (Figura 1).<\/p>\n<div class=\"wp-block-image\">\n<h5 class=\"aligncenter size-full is-resized\"><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-Angelo.jpg\" data-rel=\"penci-gallery-image-content\"  target=\"_blank\" rel=\"noreferrer noopener\" data-rel=\"penci-gallery-image-content\"><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-19175 aligncenter\" style=\"width: 408px; height: auto;\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-Angelo.jpg?v=1720646340\" sizes=\"(max-width: 734px) 100vw, 734px\" srcset=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-Angelo.jpg?v=1720646340 734w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-Angelo-300x256.jpg?v=1720646340 300w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-Angelo-585x499.jpg?v=1720646340 585w\" alt=\"\" width=\"734\" height=\"626\" \/><\/a><\/h5>\n<\/div>\n<h5 style=\"text-align: center;\"><strong><em>Figura 1: Inicio de agregaci\u00f3n plaquetaria en \u00e1rea de lesi\u00f3n de vaso <\/em><\/strong><strong><em>(adaptado de National Bleeding Disorders Foundation &#8211; hemophilia. org)<\/em><\/strong><\/h5>\n<p>En la hemostasia secundaria, la coagulaci\u00f3n sangu\u00ednea consiste en la conversi\u00f3n de una prote\u00edna soluble del plasma, <strong>el fibrin\u00f3geno<\/strong>, en un pol\u00edmero insoluble,<strong> la fibrina<\/strong>, por acci\u00f3n de una enzima denominada trombina (Figura 2).<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized wp-lightbox-container\" data-wp-context=\"{&quot;uploadedSrc&quot;:&quot;https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/post-dr-angelo-2.jpg&quot;,&quot;figureClassNames&quot;:&quot;aligncenter size-full is-resized&quot;,&quot;figureStyles&quot;:null,&quot;imgClassNames&quot;:&quot;wp-image-19176&quot;,&quot;imgStyles&quot;:&quot;width:427px;height:auto&quot;,&quot;targetWidth&quot;:950,&quot;targetHeight&quot;:781,&quot;scaleAttr&quot;:false,&quot;ariaLabel&quot;:&quot;Aumentar imagen&quot;,&quot;alt&quot;:&quot;&quot;}\" data-wp-interactive=\"core\/image\"><img decoding=\"async\" class=\"wp-image-19176 aligncenter\" style=\"width: 427px; height: auto;\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-2.jpg?v=1720646467\" sizes=\"(max-width: 950px) 100vw, 950px\" srcset=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-2.jpg?v=1720646467 950w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-2-300x247.jpg?v=1720646467 300w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-2-768x631.jpg?v=1720646467 768w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-2-585x481.jpg?v=1720646467 585w\" alt=\"\" width=\"950\" height=\"781\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on-async--click=\"actions.showLightbox\" data-wp-on-async--load=\"callbacks.setButtonStyles\" data-wp-on-async-window--resize=\"callbacks.setButtonStyles\" \/><button class=\"lightbox-trigger\" type=\"button\" aria-haspopup=\"dialog\" aria-label=\"Aumentar imagen\" data-wp-init=\"callbacks.initTriggerButton\" data-wp-on-async--click=\"actions.showLightbox\" data-wp-style--right=\"context.imageButtonRight\" data-wp-style--top=\"context.imageButtonTop\"><br \/><br \/><\/button><\/figure>\n<\/div>\n<h5 style=\"text-align: center;\"><strong><em>Figura 2: Formaci\u00f3n de fibrina en lesi\u00f3n tisular <\/em><\/strong><strong><em>(adaptado de National Bleeding Disorders Foundation &#8211; hemophilia. org)<\/em><\/strong><\/h5>\n<p>Esto ocurre con la exposici\u00f3n del factor tisular en el lugar de la lesi\u00f3n endotelial junto con las cascadas de coagulaci\u00f3n en sus v\u00edas intr\u00ednseca y extr\u00ednseca (Figura 3).<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized wp-lightbox-container\" data-wp-context=\"{&quot;uploadedSrc&quot;:&quot;https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/post-dr-angelo-3.jpg&quot;,&quot;figureClassNames&quot;:&quot;aligncenter size-full is-resized&quot;,&quot;figureStyles&quot;:null,&quot;imgClassNames&quot;:&quot;wp-image-19177&quot;,&quot;imgStyles&quot;:&quot;width:486px;height:auto&quot;,&quot;targetWidth&quot;:865,&quot;targetHeight&quot;:649,&quot;scaleAttr&quot;:false,&quot;ariaLabel&quot;:&quot;Aumentar imagen&quot;,&quot;alt&quot;:&quot;&quot;}\" data-wp-interactive=\"core\/image\"><img decoding=\"async\" class=\"wp-image-19177 aligncenter\" style=\"width: 486px; height: auto;\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-3.jpg?v=1720646582\" sizes=\"(max-width: 865px) 100vw, 865px\" srcset=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-3.jpg?v=1720646582 865w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-3-300x225.jpg?v=1720646582 300w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-3-768x576.jpg?v=1720646582 768w, https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2024\/07\/post-dr-angelo-3-585x439.jpg?v=1720646582 585w\" alt=\"\" width=\"865\" height=\"649\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on-async--click=\"actions.showLightbox\" data-wp-on-async--load=\"callbacks.setButtonStyles\" data-wp-on-async-window--resize=\"callbacks.setButtonStyles\" \/><button class=\"lightbox-trigger\" type=\"button\" aria-haspopup=\"dialog\" aria-label=\"Aumentar imagen\" data-wp-init=\"callbacks.initTriggerButton\" data-wp-on-async--click=\"actions.showLightbox\" data-wp-style--right=\"context.imageButtonRight\" data-wp-style--top=\"context.imageButtonTop\"><br \/><br \/><\/button><\/figure>\n<\/div>\n<h5 style=\"text-align: center;\"><strong><em>Figura 3: Formaci\u00f3n de fibrina en lesi\u00f3n tisular (adaptado de Parekh et al. Am J Gastroenterol 2014)<\/em> [3]<\/strong><\/h5>\n<h2 class=\"wp-block-heading\"><strong><u>F\u00e1rmacos Antitromb\u00f3ticos<\/u><\/strong><\/h2>\n<p>Adem\u00e1s de los f\u00e1rmacos antiguos como la Warfarina, un antagonista de la vitamina K con acci\u00f3n anticoagulante, y el \u00e1cido acetilsalic\u00edlico (AAS), un inhibidor de la ciclooxigenasa con efecto antiagregante plaquetario, tenemos nuevas clases de f\u00e1rmacos que ser\u00e1n discutidas a continuaci\u00f3n.<\/p>\n<h3 class=\"wp-block-heading\">\u2013 <strong>Antiagregantes plaquetarios: Tienopiridinas<\/strong><\/h3>\n<p>Las tienopiridinas act\u00faan como antagonistas del receptor P2Y12, inhibiendo la agregaci\u00f3n plaquetaria dependiente del difosfato de adenosina que es liberado tras la lesi\u00f3n endotelial, durante la hemostasia primaria. Los principales f\u00e1rmacos de este grupo son Clopidogrel (Plavix), Prasugrel (Effient) y Ticagrelor (Brillinta).<\/p>\n<h3 class=\"wp-block-heading\">\u2013 <strong>Antiagregantes plaquetarios: Inhibidores de la GPIIbIIIa<\/strong><\/h3>\n<p>Los inhibidores del complejo glicoproteico IIb\/IIIa constituyen una clase heterog\u00e9nea de f\u00e1rmacos capaces de bloquear la v\u00eda final com\u00fan de la agregaci\u00f3n plaquetaria. Para uso cl\u00ednico, por v\u00eda endovenosa, constituido por: Tirofiban (Aggrastat), Abciximab (ReoPro) y Eptifibatide (Integrilin).<\/p>\n<h3 class=\"wp-block-heading\"><strong>\u2013 Anticoagulante: Warfarina y Heparinas<\/strong><\/h3>\n<p>A pesar de poseer un largo tiempo de utilizaci\u00f3n y efectividad bien definida, la Warfarina (Warfarin, conocido como Coumadin y Marevan) posee algunas desventajas frente a los nuevos f\u00e1rmacos anticoagulantes que son: su estrecha ventana terap\u00e9utica y margen de seguridad necesitando de monitorizaci\u00f3n laboratorial frecuente, inicio lento de acci\u00f3n, con alcance de rango terap\u00e9utico solo despu\u00e9s de algunos d\u00edas en muchos casos, y la potencial influencia de la dieta y otras medicaciones en su actividad. Por otro lado, es un f\u00e1rmaco ampliamente conocido, con potencial de reversi\u00f3n de sus efectos de manera r\u00e1pida y f\u00e1cil con uso de vitamina K o incluso plasma.<\/p>\n<p>Las heparinas interact\u00faan con la antitrombina, un anticoagulante natural que inactiva los factores IXa, Xa y XIa, aumentando el efecto de este anticoagulante en m\u00e1s de 1000 veces. Representadas por la Heparina no fraccionada (HNF) y las de bajo peso molecular (HBPM), debido a su corta vida media, se utilizan como m\u00e9todo de puente: cambio de anticoagulante de larga duraci\u00f3n por corta en procedimientos de alto riesgo.<\/p>\n<h3 class=\"wp-block-heading\"><strong>\u2013 Anticoagulante: Inhibidores Xa<\/strong><\/h3>\n<p>Representados por la Rivaroxabana (Xarelto), los inhibidores del factor Xa inhiben competitivamente el factor X activado y act\u00faan en la cascada como un todo, ya que el factor X unifica las v\u00edas intr\u00ednseca y extr\u00ednseca de la coagulaci\u00f3n. Al asociarse con el factor Va el factor X forma un complejo llamado protrombinasa que act\u00faa en la transformaci\u00f3n de la protrombina en trombina. La rivaroxabana act\u00faa previniendo la formaci\u00f3n de la protrombinasa y consecuentemente de la trombina.<\/p>\n<h3 class=\"wp-block-heading\">\u00a0\u2013 <strong>Anticoagulante: Inhibidores directos de la Trombina<\/strong><\/h3>\n<p>Los inhibidores directos de la trombina est\u00e1n representados por las drogas Bivalirudina (Angiomax) y Dabigatr\u00e1n (Pradaxa). La Bivalirudina es un f\u00e1rmaco utilizado principalmente en procedimientos de intervenci\u00f3n coronaria percut\u00e1nea. Ya el Dabigatr\u00e1n es un f\u00e1rmaco aprobado en la prevenci\u00f3n de isquemia cerebral en casos de fibrilaci\u00f3n auricular no valvular y en tromboembolismo venoso.<\/p>\n<p>Vea el resumen de la tabla a continuaci\u00f3n con el tiempo de duraci\u00f3n de los antitromb\u00f3ticos equivalente al tiempo de suspensi\u00f3n en caso de que sea indicado (Tabla 1).<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized wp-lightbox-container\" data-wp-context=\"{&quot;uploadedSrc&quot;:&quot;https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/post-dr-angelo-3.jpg&quot;,&quot;figureClassNames&quot;:&quot;aligncenter size-full is-resized&quot;,&quot;figureStyles&quot;:null,&quot;imgClassNames&quot;:&quot;wp-image-19177&quot;,&quot;imgStyles&quot;:&quot;width:486px;height:auto&quot;,&quot;targetWidth&quot;:865,&quot;targetHeight&quot;:649,&quot;scaleAttr&quot;:false,&quot;ariaLabel&quot;:&quot;Aumentar imagen&quot;,&quot;alt&quot;:&quot;&quot;}\" data-wp-interactive=\"core\/image\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-19143\" src=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52-1024x855.jpg\" alt=\"\" width=\"1024\" height=\"855\" srcset=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52-1024x855.jpg?v=1749898425 1024w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52-300x251.jpg?v=1749898425 300w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52-768x642.jpg?v=1749898425 768w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52-585x489.jpg?v=1749898425 585w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-07.52.jpg?v=1749898425 1142w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><button class=\"lightbox-trigger\" type=\"button\" aria-haspopup=\"dialog\" aria-label=\"Aumentar imagen\" data-wp-init=\"callbacks.initTriggerButton\" data-wp-on-async--click=\"actions.showLightbox\" data-wp-style--right=\"context.imageButtonRight\" data-wp-style--top=\"context.imageButtonTop\"><br \/><br \/><\/button><\/figure>\n<\/div>\n<h5 class=\"aligncenter size-full is-resized wp-lightbox-container\" style=\"text-align: center;\" data-wp-context=\"{&quot;uploadedSrc&quot;:&quot;https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/post-dr-angelo-4.jpg&quot;,&quot;figureClassNames&quot;:&quot;aligncenter size-full is-resized&quot;,&quot;figureStyles&quot;:null,&quot;imgClassNames&quot;:&quot;wp-image-19178&quot;,&quot;imgStyles&quot;:&quot;width:562px;height:auto&quot;,&quot;targetWidth&quot;:898,&quot;targetHeight&quot;:741,&quot;scaleAttr&quot;:false,&quot;ariaLabel&quot;:&quot;Aumentar imagen&quot;,&quot;alt&quot;:&quot;&quot;}\" data-wp-interactive=\"core\/image\"><strong><em>Tabla 1: Tiempo de duraci\u00f3n y suspenci\u00f3n de drogas antitromb\u00f3ticas (Comisi\u00f3n Cientifica SOBED 2017-2018)<\/em><\/strong><\/h5>\n<h2>\u00a0<\/h2>\n<h2 class=\"wp-block-heading\"><strong><u>Manejo Endosc\u00f3pico<\/u><\/strong><\/h2>\n<p data-start=\"61\" data-end=\"410\">Con base en los conceptos anteriores, la forma en que abordaremos cualquier procedimiento endosc\u00f3pico se basa en la ventana terap\u00e9utica: en la que existe un menor riesgo de sangrado (bajo riesgo del procedimiento o suspensi\u00f3n de la medicaci\u00f3n antitromb\u00f3tica) frente al riesgo tromboemb\u00f3lico (enfermedad tromb\u00f3tica de base), ilustrado en la Figura 4.<\/p>\n<p data-start=\"61\" data-end=\"410\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-19144\" src=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg\" alt=\"\" width=\"950\" height=\"822\" srcset=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449 950w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10-300x260.jpg?v=1749899449 300w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10-768x665.jpg?v=1749899449 768w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10-585x506.jpg?v=1749899449 585w\" sizes=\"(max-width: 950px) 100vw, 950px\" \/><\/p>\n<h5 style=\"text-align: center;\" data-start=\"412\" data-end=\"521\"><strong>Figura 4: Ilustraci\u00f3n de la ventana terap\u00e9utica (modificado de Huo et al., <em data-start=\"491\" data-end=\"509\">Science Bulletin<\/em>, 2019) [4].<\/strong><\/h5>\n<p data-start=\"523\" data-end=\"914\">Para ello, debemos inicialmente evaluar el riesgo versus el beneficio y posponer, cuando sea posible, los procedimientos electivos hasta que se haya completado la terapia antitromb\u00f3tica a corto plazo. Antes de suspender cualquier medicaci\u00f3n antitromb\u00f3tica, el paciente deber\u00e1 ser evaluado por su m\u00e9dico prescriptor con respecto a la suspensi\u00f3n de los medicamentos y la indicaci\u00f3n del examen.<\/p>\n<p data-start=\"916\" data-end=\"1115\" data-is-last-node=\"\" data-is-only-node=\"\">Una vez indicado el examen, el primer paso es proceder con la estratificaci\u00f3n del riesgo de sangrado del procedimiento, seguido de la estratificaci\u00f3n del riesgo tromboemb\u00f3lico y la conducta a seguir.<\/p>\n<p data-start=\"916\" data-end=\"1115\" data-is-last-node=\"\" data-is-only-node=\"\">\u00a0<\/p>\n<h3 class=\"wp-block-heading\">Riesgo de sangramiento del procedimiento\u00a0<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-19147\" src=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-1024x633.png\" alt=\"\" width=\"1024\" height=\"633\" srcset=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-1024x633.png 1024w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-300x185.png 300w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-768x474.png 768w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-1170x723.png 1170w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32-585x361.png 585w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.18.32.png 1282w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/p>\n<h5 style=\"text-align: center;\" data-start=\"412\" data-end=\"521\"><strong>Tabla 2: Estratificaci\u00f3n de Riesgo de sangramiento del procedimiento<\/strong><\/h5>\n<h3>\u00a0<\/h3>\n<h3 class=\"wp-block-heading\">Riesgo Tromboemb\u00f3lico<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-19148\" src=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-1024x632.png\" alt=\"\" width=\"1024\" height=\"632\" srcset=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-1024x632.png 1024w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-300x185.png 300w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-768x474.png 768w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-1170x722.png 1170w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21-585x361.png 585w, https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Captura-de-Tela-2025-06-14-a\u0300s-10.19.21.png 1284w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/p>\n<h5 style=\"text-align: center;\" data-start=\"412\" data-end=\"521\"><strong>Tabla 3: Estratificaci\u00f3n de riesgo tromboemb\u00f3lico<\/strong><\/h5>\n<p>\u00a0<\/p>\n<h2 class=\"wp-block-heading\"><strong><u>Conducta<\/u><\/strong><\/h2>\n<h3 class=\"wp-block-heading\">Procedimiento de BAJO riesgo de sangrado<\/h3>\n<ul>\n<li data-start=\"61\" data-end=\"410\">Mantener antiagregaci\u00f3n;<\/li>\n<li data-start=\"61\" data-end=\"410\">Mantener Varfarina si esta dentro de rango terap\u00e9utico, caso contrario aguardar correcci\u00f3n de dosis por el especialista;<\/li>\n<li data-start=\"61\" data-end=\"410\">Suspender otros anticoagulantes solamente en el d\u00eda;<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Procedimiento de ALTO riesgo de sangrado<\/h3>\n<ul>\n<li data-start=\"61\" data-end=\"410\">Suspender Clopidrogel, Ticagrelol o Prasugrel 7 dias antes de reiniciar y reiniciar 1 a 2 d\u00edas despu\u00e9s del procedimiento, manteniendo siempre la ASA;<\/li>\n<li data-start=\"61\" data-end=\"410\">Suspender anticoagulantes orales directos (DOAC &#8211; Direct Oral AntiCoagulants: Dabigatrana, Rivaroxabana, Apixabana e Edoxabana) 3 d\u00edas antes, siendo 5 d\u00edas se insuficiencia renal con clearance de 30-50 mL\/min, e retornar en 2 a 3 d\u00edas despu\u00e9s del procedimiento;<\/li>\n<li data-start=\"61\" data-end=\"410\">Suspender Varfarina 5 dias antes (verificar si INR &lt; 1,5 antes del examen) y retornar a la dosis usual al final del d\u00eda del procedimiento;<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Procedimiento de ALTO riesgo de sangrado y ALTO riesgo tromboembolico<\/h3>\n<ul>\n<li data-start=\"61\" data-end=\"410\">Suspender Clopidrogel, Ticagrelol o Prasugrel 7 d\u00edas antes de reiniciar y reiniciar 2 d\u00edas despu\u00e9s del procedimiento, manteniendo siempre la ASA;<\/li>\n<li data-start=\"61\" data-end=\"410\">Suspender anticoagulantes orales directos (DOAC &#8211; Direct Oral AntiCoagulants: Dabigatrana, Rivaroxabana, Apixabana e Edoxabana) 3 d\u00edas antes, siendo 5 d\u00edas se insuficiencia renal con clearance de 30-50 mL\/min, e retornar em 2 a 3 d\u00edas despu\u00e9s del procedimiento;<\/li>\n<li data-start=\"61\" data-end=\"410\"><strong>Realizar puente de anticoagulaci\u00f3n:<\/strong> Suspender Varfarina 5 d\u00edas antes con inicio de HBPM (Enoxaparina) 3 d\u00edas antes del procedimiento, seguida de suspenci\u00f3n en el d\u00eda del procedimiento. Retornar al uso de Varfarina en el fin del d\u00eda del procedimiento, manteniendo HBPM at\u00e9 rango de INR terap\u00e9utico.<\/li>\n<\/ul>\n<p>Mantener ASA en todos los casos, principalmente para prevenci\u00f3n secundaria. Las excepciones son: suspender inmediatamente un cuadro agudo de sangramiento, prevenci\u00f3n primaria que puede ser suspendida 5 d\u00edas antes en procedimientos de alto riesgo de sangrado y seg\u00fan la ESGE, suspender para ampulectomia. [1,5]<\/p>\n<p>En casos de alto riesgo tromboemb\u00f3lico de pacientes con stent coronariano o dudas de riesgo tromboemb\u00f3lico, se recomienda evaluaci\u00f3n del cardiologista para manejo de antiagregaci\u00f3n y anticoagulaci\u00f3n.<\/p>\n<p>\u00a0<\/p>\n\n\n<h2 class=\"wp-block-heading\"><strong>Refer\u00eancias<\/strong>:<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Veitch AM, Radaelli F, Alikhan R, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Endoscopy. 2021 Sep;53(9):947-969. doi: 10.1055\/a-1547-2282. Epub 2021 Aug 6. PMID: 34359080; PMCID: PMC8390296.<\/li>\n\n\n\n<li>ASGE Standards of Practice Committee; Acosta RD, Abraham NS, et al. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016 Jan;83(1):3-16. doi: 10.1016\/j.gie.2015.09.035. Epub 2015 Nov 24. Erratum in: Gastrointest Endosc. 2016 Mar;83(3):678. PMID: 26621548.<\/li>\n\n\n\n<li>Parekh PJ, Merrell J, Clary M, Brush JE, Johnson DA. New anticoagulants and antiplatelet agents: a primer for the clinical gastroenterologist. Am J Gastroenterol. 2014 Jan;109(1):9-19. doi: 10.1038\/ajg.2013.228. PMID: 24402526.<\/li>\n\n\n\n<li>Huo Y, Jeong YH, Gong Y, et al. 2018 update of expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI. Sci Bull (Beijing). 2019 Feb 15;64(3):166-179. doi: 10.1016\/j.scib.2018.12.020. Epub 2018 Dec 28. PMID: 36659616.<\/li>\n\n\n\n<li>Biondi-Zoccai GG, Lotrionte M, Agostoni P, et al. A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. Eur Heart J. 2006 Nov;27(22):2667-74. doi: 10.1093\/eurheartj\/ehl334. Epub 2006 Oct 19. PMID: 17053008.<\/li>\n<\/ol>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>El t\u00e9rmino antitromb\u00f3tico compila los f\u00e1rmacos que poseen efecto antiagregante plaquetario o anticoagulante. Muchos&hellip;<\/p>\n","protected":false},"author":5611,"featured_media":19144,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[],"ano":[750],"tipo":[159],"volume":[263],"class_list":["post-19015","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-temas-generales","ano-750","tipo-otros","volume-volumen-i"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda &#8226; Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda\" \/>\n<meta property=\"og:description\" content=\"El t\u00e9rmino antitromb\u00f3tico compila los f\u00e1rmacos que poseen efecto antiagregante plaquetario o anticoagulante. Muchos pacientes han estado usando estas\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeuticaes\" \/>\n<meta property=\"article:published_time\" content=\"2025-06-14T14:11:12+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-06-14T14:12:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449\" \/>\n\t<meta property=\"og:image:width\" content=\"950\" \/>\n\t<meta property=\"og:image:height\" content=\"822\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/\"},\"author\":{\"name\":\"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#\\\/schema\\\/person\\\/ee63fedb4c5894303b3c16bdc0dd8d59\"},\"headline\":\"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda\",\"datePublished\":\"2025-06-14T14:11:12+00:00\",\"dateModified\":\"2025-06-14T14:12:28+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/\"},\"wordCount\":1638,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449\",\"articleSection\":[\"Temas generales\"],\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/\",\"name\":\"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda &#8226; Endoscopia Terapeutica\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449\",\"datePublished\":\"2025-06-14T14:11:12+00:00\",\"dateModified\":\"2025-06-14T14:12:28+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#primaryimage\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2024\\\/07\\\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449\",\"width\":950,\"height\":822},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/temas-generales\\\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#website\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/\",\"name\":\"Endoscopia Terapeutica\",\"description\":\"Uniendo conocimiento acad\u00e9mico con habilidad cl\u00ednica, Endoscopia Terap\u00eautica es tu gu\u00eda para el progreso en endoscopia digestiva. Educa y enriquece tu pr\u00e1ctica con nosotros.\",\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#organization\",\"name\":\"Endoscopia Terapeutica\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"width\":720,\"height\":721,\"caption\":\"Endoscopia Terapeutica\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/endoscopiaterapeuticaes\",\"https:\\\/\\\/www.instagram.com\\\/endoscopia_terapeutica\\\/\",\"https:\\\/\\\/www.youtube.com\\\/@endoscopyonline\"]},[{\"@type\":[\"Person\"],\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#\\\/schema\\\/person\\\/ee63fedb4c5894303b3c16bdc0dd8d59\",\"name\":\"Angelo So Taa Kum\",\"image\":{\"@type\":\"ImageObject\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/01\\\/angelo-e1673705942588.jpg\",\"inLanguage\":\"es_ES\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/01\\\/angelo-e1673705942588.jpg\",\"caption\":\"Angelo So Taa Kum\"}},{\"@type\":[\"Person\"],\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/#\\\/schema\\\/person\\\/ee63fedb4c5894303b3c16bdc0dd8d59\",\"name\":\"Cesar Saul Quevedo Penaloza\",\"image\":{\"@type\":\"ImageObject\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/01\\\/angelo-e1673705942588.jpg\",\"inLanguage\":\"es_ES\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/02536512895ed614d900e1a771cfd3250f989865166a8271402e57907574c10f?s=96&d=mm&r=g\",\"caption\":\"Cesar Saul Quevedo Penaloza\"}}]]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda &#8226; Endoscopia Terapeutica","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/","og_locale":"es_ES","og_type":"article","og_title":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda","og_description":"El t\u00e9rmino antitromb\u00f3tico compila los f\u00e1rmacos que poseen efecto antiagregante plaquetario o anticoagulante. Muchos pacientes han estado usando estas","og_url":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/","og_site_name":"Endoscopia Terapeutica","article_publisher":"https:\/\/www.facebook.com\/endoscopiaterapeuticaes","article_published_time":"2025-06-14T14:11:12+00:00","article_modified_time":"2025-06-14T14:12:28+00:00","og_image":[{"width":950,"height":822,"url":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449","type":"image\/jpeg"}],"author":"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza","Tiempo de lectura":"9 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#article","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/"},"author":{"name":"Angelo So Taa Kum&nbsp;e&nbsp;Cesar Saul Quevedo Penaloza","@id":"https:\/\/endoscopiaterapeutica.net\/es\/#\/schema\/person\/ee63fedb4c5894303b3c16bdc0dd8d59"},"headline":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda","datePublished":"2025-06-14T14:11:12+00:00","dateModified":"2025-06-14T14:12:28+00:00","mainEntityOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/"},"wordCount":1638,"commentCount":0,"publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#organization"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449","articleSection":["Temas generales"],"inLanguage":"es","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/","url":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/","name":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda &#8226; Endoscopia Terapeutica","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#website"},"primaryImageOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#primaryimage"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449","datePublished":"2025-06-14T14:11:12+00:00","dateModified":"2025-06-14T14:12:28+00:00","breadcrumb":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#breadcrumb"},"inLanguage":"es","potentialAction":[{"@type":"ReadAction","target":["https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/"]}]},{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#primaryimage","url":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449","contentUrl":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2024\/07\/Imagem-14-06-2025-a\u0300s-08.10.jpg?v=1749899449","width":950,"height":822},{"@type":"BreadcrumbList","@id":"https:\/\/endoscopiaterapeutica.net\/es\/temas-generales\/antitromboticos-antiagregantes-y-anticoagulantes-manejo-en-endoscopia\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/endoscopiaterapeutica.net\/es\/"},{"@type":"ListItem","position":2,"name":"Antitromb\u00f3ticos (Antiagregantes y Anticoagulantes): Manejo en Endoscop\u00eda"}]},{"@type":"WebSite","@id":"https:\/\/endoscopiaterapeutica.net\/es\/#website","url":"https:\/\/endoscopiaterapeutica.net\/es\/","name":"Endoscopia Terapeutica","description":"Uniendo conocimiento acad\u00e9mico con habilidad cl\u00ednica, Endoscopia Terap\u00eautica es tu gu\u00eda para el progreso en endoscopia digestiva. Educa y enriquece tu pr\u00e1ctica con nosotros.","publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/endoscopiaterapeutica.net\/es\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"es"},{"@type":"Organization","@id":"https:\/\/endoscopiaterapeutica.net\/es\/#organization","name":"Endoscopia Terapeutica","url":"https:\/\/endoscopiaterapeutica.net\/es\/","logo":{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/endoscopiaterapeutica.net\/es\/#\/schema\/logo\/image\/","url":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2023\/09\/endter.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2023\/09\/endter.jpg","width":720,"height":721,"caption":"Endoscopia Terapeutica"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/endoscopiaterapeuticaes","https:\/\/www.instagram.com\/endoscopia_terapeutica\/","https:\/\/www.youtube.com\/@endoscopyonline"]},[{"@type":["Person"],"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#\/schema\/person\/ee63fedb4c5894303b3c16bdc0dd8d59","name":"Angelo So Taa Kum","image":{"@type":"ImageObject","@id":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2023\/01\/angelo-e1673705942588.jpg","inLanguage":"es_ES","url":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2023\/01\/angelo-e1673705942588.jpg","caption":"Angelo So Taa Kum"}},{"@type":["Person"],"@id":"https:\/\/endoscopiaterapeutica.net\/es\/#\/schema\/person\/ee63fedb4c5894303b3c16bdc0dd8d59","name":"Cesar Saul Quevedo Penaloza","image":{"@type":"ImageObject","@id":"https:\/\/endoscopiaterapeutica.net\/es\/wp-content\/uploads\/2023\/01\/angelo-e1673705942588.jpg","inLanguage":"es_ES","url":"https:\/\/secure.gravatar.com\/avatar\/02536512895ed614d900e1a771cfd3250f989865166a8271402e57907574c10f?s=96&d=mm&r=g","caption":"Cesar Saul Quevedo Penaloza"}}]]}},"_links":{"self":[{"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/posts\/19015","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/users\/5611"}],"replies":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/comments?post=19015"}],"version-history":[{"count":2,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/posts\/19015\/revisions"}],"predecessor-version":[{"id":19152,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/posts\/19015\/revisions\/19152"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/media\/19144"}],"wp:attachment":[{"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/media?parent=19015"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/categories?post=19015"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/tags?post=19015"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/ano?post=19015"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/tipo?post=19015"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/es\/wp-json\/wp\/v2\/volume?post=19015"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}