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Simultaneous dual coronary very late stent thrombosis following noncardiac surgery

Shailja V Parikh1, Ashish Parikh, Emmanouil S Brilakis

  • 1Division of Cardiovascular Diseases, VA North Texas Healthcare System, University of Texas Southwestern Medical Center, Dallas, TX 75216, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|July 6, 2010
PubMed

Insights

Patients with drug-eluting stents (DES) face risks during noncardiac surgery. Discontinuing antiplatelet therapy for surgery can lead to dangerous stent thrombosis, even years after DES placement.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Managing patients with drug-eluting stents (DES) undergoing noncardiac surgery presents a clinical dilemma.
  • Balancing the risk of surgical bleeding against the risk of stent thrombosis from interrupted dual antiplatelet therapy is critical.

Observation:

  • A case report details a patient who experienced simultaneous stent thrombosis in two coronary arteries.
  • This event occurred after clopidogrel discontinuation for an elective noncardiac surgery.

Findings:

  • The patient had drug-eluting stents placed 3 years prior to the noncardiac surgery.
  • Discontinuation of dual antiplatelet therapy, specifically clopidogrel, preceded the thrombotic event.

Implications:

  • This case highlights the potential for late stent thrombosis in patients with DES, even years after implantation.
  • Careful consideration of antiplatelet therapy management is crucial for patients with DES undergoing noncardiac procedures.
  • Further research into optimal perioperative management strategies for these patients is warranted.

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