Ultrasound-Guided Thoracentesis is Probably Safe Even When Patients are Taking Clopidogrel (Plavix)

by Joseph Esherick, M.D., FAAFP, FHM

A prospective cohort single center study was conducted to analyze the risk associated with patients undergoing thoracentesis or small-bore chest tube placement while taking clopidogrel. Twenty-five patients taking clopidogrel gave consent to remain on the antiplatelet medication while undergoing thoracentesis or small-bore chest tube placement. Meanwhile, 50 other patients not taking clopidogrel underwent the same procedures and were observed as a control group. An interventional pulmonologist or a supervised pulmonary fellow performed all of the procedures using ultrasound guidance.

Only one patient from the clopidogrel group had a case of hemothorax following thoracentesis and there were no cases in the control group. Overall, there were no statistically significant differences in severe bleeding complications in patients taking clopidogrel. Nevertheless, a large randomized clinical trial is necessary to determine the safety of performing these procedures while the patient is taking clopidogrel.

 

 

Mahmood K., et al. Hemorrhagic complications of thoracentesis and small-bore chest tube placement in patients taking clopidogrel. Ann Am Thorac Soc. 2014 Jan;11(1):73-9