Perioperative management of patient with intracoronary stent presenting for noncardiac surgery.

摘要: As the number of percutaneous coronary interventions increase annually, patients with intracoronary stents (ICS) who present for noncardiac surgery (NCS) are also on rise. ICS is associated stent thrombosis (STH) and requires mandatory antiplatelet therapy to prevent major adverse cardiac events. The risks bleeding ischemia remain significant management these patients, especially in initial year challenging. American College Cardiologists guidelines recommend dual (DAT) minimal 14 days after balloon angioplasty, 30 bare metal stents, 365 drug-eluting stents. Postponement elective advocated during this period, but concerning emergency NCS ambiguous. risk STH surgical needs be assessed carefully many factors which implicated STH, apart from type duration DAT, need considered when decision discontinue DAT made. should a multidisciplinary exercise bridging shorter acting intravenous drugs contemplated whenever possible. Well conducted clinical trials needed establish as regards appropriate tests platelet function monitoring undergoing while DAT.