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Related Experiment Video

Updated: Jun 5, 2026

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
09:02

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Published on: July 31, 2016

Perioperative antiplatelet therapy.

Pierre Guy Chassot1, Carlo Marcucci, Alain Delabays

  • 1Institute of Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland. pgchassot@bluewin.ch

American Family Physician
|December 21, 2010
PubMed
Summary
This summary is machine-generated.

For patients with cardiovascular disease, continuing antiplatelet therapy during surgery generally outweighs bleeding risks, especially for stented individuals. Elective surgery should be delayed post-stenting or myocardial infarction to minimize cardiac event risks.

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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Lifelong aspirin therapy is standard for cardiovascular disease.
  • Clopidogrel therapy duration varies based on stent type and myocardial infarction history.
  • Surgery induces a hypercoagulable state, increasing risks for patients on antiplatelet therapy.

Purpose of the Study:

  • To evaluate the risks of cardiovascular events versus surgical bleeding when withdrawing or continuing antiplatelet therapy before surgery.
  • To provide guidance on managing antiplatelet therapy in patients undergoing surgery.

Main Methods:

  • Clinical data review comparing cardiovascular event rates and surgical bleeding risks.
  • Analysis of risk factors, including time from revascularization to surgery and type of antiplatelet therapy.

Main Results:

  • Withdrawing antiplatelet therapy increases postoperative myocardial infarction and death risk 5-10 fold in stented patients.
  • The risk of cardiovascular events from stopping therapy is generally higher than surgical bleeding risk.
  • Dual antiplatelet therapy increases surgical hemorrhage risk by approximately 50%.

Conclusions:

  • Continue dual antiplatelet therapy for urgent surgeries or when cardiovascular risk outweighs bleeding risk.
  • Postpone elective surgery beyond recommended antiplatelet therapy durations.
  • Exceptions for continuation include intracranial surgery or procedures with high bleeding risk.