Key result
Cangrelor bridging facilitates successful emergency spine surgery off oral antiplatelets in a recent DES case.
Why the study?
The recommended duration of DAPT after drug-eluting stent placement creates a dilemma for patients with recent stenting who need urgent or emergency noncardiac surgery.
Can cangrelor be safely used to bridge antiplatelet therapy in patients with recent drug-eluting stent placement requiring emergency cervical spine surgery?
Case Report (n=1)
Can cangrelor be safely used to bridge antiplatelet therapy in patients with recent drug-eluting stent placement requiring emergency cervical spine surgery?
Cangrelor bridging may be a feasible multidisciplinary strategy for patients with recent drug-eluting stents who require emergency surgery with high bleeding risk, such as neurosurgery, while off oral antiplatelet therapy.
May support cangrelor bridging in select recent-DES patients needing urgent surgery off DAPT; leaves open need for prospective validation.
The recommended duration of dual antiplatelet therapy after drug-eluting stent placement presents a dilemma for patients with recent stenting who require urgent or emergency noncardiac surgery. We present the case of a patient with recent drug-eluting stent placement (<6 months) on dual antiplatelet therapy who underwent successful emergency cervical spine surgery with antiplatelet therapy bridged using cangrelor, an intravenous P2Y12 inhibitor antiplatelet agent. Our experience illustrates the multidisciplinary approach to a patient with high thrombotic and bleeding risk who underwent neurosurgery off both aspirin and a P2Y12 inhibitor.
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Hu et al. (2019) conducted a case report in Recent drug-eluting stent placement requiring emergency cervical spine surgery (n=1). Cangrelor bridging was evaluated on Successful emergency cervical spine surgery. Cangrelor bridging was successfully used in a patient with a recent drug-eluting stent (<6 months) who required emergency cervical spine surgery off both aspirin and an oral P2Y12 inhibitor.
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