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Updated: May 28, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Bridging therapy after recent stent implantation: case report and review of data
Jeffrey D Wessler1, Fidencio Saldana, Robert P Giugliano
1Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Insights
Managing patients needing surgery after coronary stent placement presents a challenge. This study explores using short-acting glycoprotein IIb/IIIa inhibitors as bridge therapy to prevent stent thrombosis while minimizing bleeding risks.
Area of Science:
- Cardiology
- Oncology
- Anesthesiology
Background:
- Patients with recent coronary stents undergoing surgery face a dual risk of stent thrombosis and bleeding.
- Balancing antiplatelet therapy for stent patency with surgical hemostasis is complex.
Observation:
- A case report details bridging a patient with drug-eluting stents (placed 7 months prior) with intravenous eptifibatide before bronchoscopy for suspected lung cancer.
- Eptifibatide, a short-acting glycoprotein (GP) IIb/IIIa inhibitor, was administered for 3 days pre-procedure.
Findings:
- The manuscript reviews current literature and guidelines on using short-acting GP IIb/IIIa inhibitors as perioperative bridge therapy.
- This review synthesizes data to inform management strategies.
Implications:
- Provides recommendations for perioperative bridge therapy in patients with recent coronary stents.
- Aims to guide cardiologists, surgeons, and anesthesiologists in managing these high-risk patients.
- Highlights the role of short-acting GP IIb/IIIa inhibitors in balancing thrombosis prevention and bleeding risk.
Abstract:
For patients requiring surgery within their first year following coronary stent placement, maximizing the prevention of stent thrombosis with antiplatelet therapy while minimizing the risk of intraoperative bleeding has become a management challenge for cardiologists, surgeons and anesthesiologists. In this manuscript, we describe a case of a patient who received three stents (two of which were drug-eluting) and 7 months later was bridged with intravenous eptifibatide, a short-acting glycoprotein (GP) IIb/IIIa inhibitor, for 3 days prior to bronchoscopy and cervical mediastinoscopy for a suspected lung cancer. We then review the current literature for data and guidelines describing the use of short-acting GP IIb/IIIa as bridge therapy. Finally, we provide recommendations, based on our experience combined with this review, for bridge therapy in the perioperative period for patients with recent coronary stents.
