Why the study?
Does cangrelor bridge therapy prevent ischemic or bleeding complications in a patient on DAPT requiring urgent noncardiac surgery?
Does cangrelor bridge therapy prevent ischemic or bleeding complications in a patient on DAPT requiring urgent noncardiac surgery?
Cangrelor bridge therapy may be a safe option for patients on DAPT requiring urgent noncardiac procedures like bronchoscopy with biopsy.
Answers are grounded in this paper and cite their sources.
May support cangrelor bridging in DAPT patients needing urgent surgery; hypothesis-generating case report, prospective trials needed.
Although premature discontinuation of dual antiplatelet therapy (DAPT) is associated with an increased risk of ischemic complications, patients may present with an urgent need for surgery that would require interruption of DAPT. Antiplatelet bridge therapy using cangrelor, an intravenous P2Y 12 inhibitor, has been studied as a potential option to ensure continuation of DAPT perioperatively. However, limited evidence exists supporting the off-label use of cangrelor bridge therapy to noncardiac procedures. We describe the case of a 67-year-old class 3 obese female on DAPT (aspirin and ticagrelor) for recent drug-eluting stent placement who required a bronchoscopy with biopsy for suspected lung cancer. Cangrelor bridge therapy was utilized both preoperatively and postoperatively without ischemic or bleeding complications, and the patient was subsequently able to begin radiation therapy after a confirmed diagnosis of lung cancer.
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Calnan et al. (2018) studied this question.
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