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We clarified the incidence of delayed bleeding in patients who were on edoxaban in the perioperative period of gastrointestinal endoscopic procedures with a high risk of bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an investigator\u2010initiated, single\u2010center, open\u2010label, prospective, single\u2010arm study. Patients on warfarin or edoxaban undergoing endoscopy with a high risk of bleeding were enrolled from June 2018 to September 2021. Warfarin was replaced with edoxaban in patients on warfarin. Patients taking other direct oral anticoagulants, and antiplatelet drugs, were excluded. The primary endpoint was severe delayed bleeding (Common Terminology Criteria for Adverse Events [CTCAE] grades III\u2013V) and the secondary endpoints included thromboembolism, all adverse events, any delayed bleeding (CTCAE grades I or II), and hospital stay durations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010one patients on edoxaban underwent high\u2010risk endoscopy. Three cases (14%) experienced CTCAE grade III delayed bleeding, requiring endoscopic hemostasis. No CTCAE grade I\u2010II delayed bleeding or thromboembolic events occurred. Cholangitis and aspiration pneumonia (conservatively treated) occurred during the hospital stay. The median length of hospital stay was 8 days (range 3\u201424 days). Patients with delayed bleeding had higher systolic blood pressure at admission and longer hospital stays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The delayed bleeding incidence in high\u2010risk endoscopic procedures for patients on edoxaban was acceptable. Higher blood pressure may be associated with increased risk, but further research is needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/deo2.70018","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T05:50:40Z","timestamp":1728021040000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of edoxaban for delayed bleeding in gastrointestinal endoscopic procedures with a high risk of bleeding"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9622-9250","authenticated-orcid":false,"given":"Ken\u2010ichi","family":"Mizuno","sequence":"first","affiliation":[{"name":"Department of Endoscopy Niigata University Medical and Dental Hospital  Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junji","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Niigata Hospital  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