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[Drug eluting stents and anticoagulation in the perioperative setting - an interdisciplinary challenge]

Benedikt Preckel1, Wolfgang Schlack

  • 1Leitender Oberarzt an der Klinik für Anästhesiologie, Academic Medical Center, Universität von Amsterdam, Niederlande. b.preckel@amc.uva.nl

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|September 17, 2008
PubMed

Insights

Drug-eluting stents require prolonged anticoagulation to prevent thrombosis. Anti-platelet therapy with clopidogrel and aspirin should continue perioperatively when possible for cardiac patients.

Area of Science:

  • Cardiovascular medicine
  • Interventional cardiology

Context:

  • Drug-eluting stents (DES) are increasingly used in patients with cardiac risk undergoing coronary interventions.
  • DES implantation necessitates extended anticoagulation (≥1 year) to mitigate acute stent thrombosis risk.

Purpose:

  • To outline the perioperative management of anti-platelet therapy in patients with DES.
  • To emphasize the importance of continued anti-platelet medication for preventing stent thrombosis.

Summary:

  • Perioperative continuation of anti-platelet drugs, specifically clopidogrel and aspirin, is recommended if feasible for patients with DES.
  • Stopping anti-platelet therapy requires careful consideration and should be decided on a case-by-case basis.

Impact:

  • Informed clinical decisions regarding anti-platelet therapy in DES patients.
  • Reduced risk of perioperative stent thrombosis and improved patient outcomes.
  • Highlights the need for multidisciplinary collaboration among cardiologists, surgeons, and anesthesiologists.

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