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This case highlights the severe risk of fatal perioperative stent thrombosis when noncardiac surgery is performed early (37 days) after bare-metal stent implantation, even with aspirin continuation.
Perioperative coronary stent thrombosis is a life-threatening complication for patients undergo noncardiac surgery early after stent implantation. We present a case of fatal stent thrombosis immediately after revision total knee replacement (TKR)in 71-year-old woman, who underwent multiple bare-metal stents (BMSs) implantation 37 days before surgery. She had previously undergone emergency surgery due to septic knee arthritis before BMS implantation. Dual-antiplatelet therapy with aspirin and clopidogrel were administered four week, and then aspirin alone was continued until the day of surgery. However, within 1 hour after revision TKR, total stent occlusion of the left anterior descending artery and near total thrombotic occlusion of obtuse marginal artery oswere developed due to the antiplatelet drug resistance, which is one of the strongly suspected predictor. Unfortunately she was died despite of the successful coronary blood flow recoveries.
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A 2016 study studied this question.
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