Why the study?
What is the optimal perioperative management and timing for noncardiac surgery in patients with recent percutaneous coronary intervention?
What is the optimal perioperative management and timing for noncardiac surgery in patients with recent percutaneous coronary intervention?
This review highlights the critical importance of delaying elective noncardiac surgery and carefully managing dual antiplatelet therapy in patients with recent coronary stents to prevent fatal stent thrombosis.
Urges individualized perioperative planning post-PCI; supports guidelines yet leaves optimal DAPT strategies open for prospective trials.
The management of patients with recent coronary artery stents presenting for noncardiac surgery has become a major topic of interest and concern for all perioperative caregivers. Perioperative coronary stent thrombosis is a catastrophic complication that occur in patients receiving both bare-metal and drug-iluting stents. Noncardiac surgery appears to increase the risk that recently-placed stents thrombose, especially when surgery is performed early after stenting, and particularly if dual antiplatelet therapy is discontinued. This review examines the available literature on the perioperative management of these patients. I reviewed the existing data about the present method of percutaneous coronary intervention; the different types of coronary stent currently available; recommended time interval for each procedure to proceed to the operation; antiplatelet therapy for prevention of stent thrombosis; and the recommended antiplatelet regimens that the patient with a coronary stent will be receiving. (Korean J Anesthesiol 2008; 55: 18)
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Hye Won Lee (2008) studied this question.
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