R. M. Kholmatov1, T. A. Hassoon1, Z. Al-Qurayshi1, M. Anwar1, F. Murad1, H. Mahmood1, T. K. Thethi2, R. Aslam3, E. Kandil1 1Tulane University School Of Medicine,Surgery,New Orleans, LA, USA 2Tulane University School Of Medicine,Endocrinology,New Orleans, LA, USA 3Tulane University School Of Medicine,Otolaryngology,New Orleans, LA, USA
Introduction: Fine needle aspiration biopsy (FNAB) is relatively contraindicated in patients with suspicious thyroid nodules while on anticoagulant and antiplatelet agents. Our aim is to evaluate the bleeding risk associated with anticoagulation and antithrombotic therapy in patients presenting for FNAB of thyroid nodules.
Methods: After approval from institutional review board, we performed retrospective analysis of patients’ records who underwent FNAB of thyroid nodules by a single surgeon over past 5 years. 608 patients with a mean age of 53.12±14.08 years underwent FNAB of thyroid nodules. 140 (23 %) patients were on anticoagulants (warfarin, heparin, apixaban) or antiplatelet agents (aspirin, clopidogrel). We collected data on patients’ demographic and social history along with the postoperative diagnosis. Statistical analysis was performed using student's t test and Fisher’s exact test for the continuous and categorical variables respectively.
Results: Four out of 468 patients in the control group developed a small hematoma after FNAB, as compared to only one patient in the other group, who was taking warfarin and aspirin (OR 7.93; 95% CI 0.83-75.59, p=0.07). Patients with post FNAB hematomas were managed conservatively without a need for surgical intervention. There was no correlation between post FNAB hematoma and patients’ demographics, social history, ultrasonographic features, or postoperative diagnosis (p>0.05).
Conclusion: FNAB of thyroid nodules in patients who are undergoing anticoagulation is a safe and feasible approach without the need to discontinue anticoagulant therapy. However, further future prospective studies are warranted.