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01.10.2011 | Current Opinion

Management of Antiplatelet Therapy in Patients at Risk for Coronary Stent Thrombosis Undergoing Non-Cardiac Surgery

verfasst von: Associate Professor Zuzana Motovska, MD, PhD, FESC

Erschienen in: Drugs | Ausgabe 14/2011

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Abstract

Percutaneous coronary interventions (PCIs) have become the most commonly performed coronary revascularization procedures. At the same time, there is an increased likelihood that patients with intracoronary stents will need to undergo surgery. Two serious consequences emerge from this situation: (i) stent thrombosis in relation to discontinuation of antiplatelet therapy, and (ii) major bleeding in relation to continuation of antiplatelet therapy. The best solution to overcome the risks resulting from surgery performed in patients after stent implantation is to postpone the operation until after re-endothelialization of the vessel surface is completed. Expert recommendations advise that patients can be sent for non-cardiac surgery 3 months after bare-metal stent PCI and 12 months after drug-eluting stent PCI, with continuation of aspirin therapy. Difficult decisions regarding antiplatelet management arise when a patient that is still receiving dual antiplatelet therapy with aspirin and a thienopyridine has to undergo surgery that cannot be postponed. Discussions between the treating cardiologist, the surgeon and the anaesthesiologist about this situation are recommended in order to achieve a reasonable expert consensus.

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Titel: Management of Antiplatelet Therapy in Patients at Risk for Coronary Stent Thrombosis Undergoing Non-Cardiac Surgery
verfasst von: Associate Professor Zuzana Motovska, MD, PhD, FESC
Publikationsdatum: 01.10.2011
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 14/2011
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/11594260-000000000-00000

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Management of Antiplatelet Therapy in Patients at Risk for Coronary Stent Thrombosis Undergoing Non-Cardiac Surgery

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