Document Detail


The management of antiplatelet therapy in patients with coronary stents undergoing noncardiac surgery.
MedLine Citation:
PMID:  21059610     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Whereas the development of coronary stents has been a major breakthrough in the treatment of coronary artery disease, stent thrombosis, associated with myocardial infarction and death, has introduced a new challenge in the care of patients with coronary stents undergoing noncardiac surgery. This review presents the authors' recommendations regarding the optimal management of such patients. Elective surgery should be postponed for at least 6 weeks and optimally 3 months for a bare-metal stent and at least 1 year for a drug-eluting stent. On the other hand, managing a patient undergoing non-elective surgery is more difficult and necessitates a case-by-case assessment of bleeding risk versus thrombotic risk based on patient comorbidities, type of stents present, details of the coronary intervention, and type of surgical procedure. Patients with a risk of bleeding that outweighs the risk of stent thrombosis should discontinue at least clopidogrel, whereas all other patients should continue dual antiplatelet therapy throughout the perioperative period.
Authors:
Tzong-Huei Chen; Robina Matyal
Publication Detail:
Type:  Journal Article     Date:  2010-11-07
Journal Detail:
Title:  Seminars in cardiothoracic and vascular anesthesia     Volume:  14     ISSN:  1940-5596     ISO Abbreviation:  Semin Cardiothorac Vasc Anesth     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9807630     Medline TA:  Semin Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-73     Citation Subset:  IM    
Affiliation:
Beth Israel Deaconess Medical Center, Boston, MA, USA. herbchen@gmail.com
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