[Perioperative anti-platelet therapy management--protocol suggestion]

Area of Science:

• Cardiology
• Vascular Surgery
• Pharmacology

Background:

• Dual antiplatelet therapy with aspirin and clopidogrel is standard but poses risks when interrupted for surgery.
• Withholding antiplatelet treatment increases perioperative thromboembolic risk.
• Current management strategies for perioperative antiplatelet therapy are inadequate.

Purpose of the Study:

• To present a novel perioperative antiplatelet management protocol.
• To guide physicians in managing dual antiplatelet therapy in patients undergoing surgery.
• To mitigate perioperative thromboembolic and bleeding risks.

Main Methods:

• A three-step protocol assessing treatment indication, thrombotic risk, and surgical bleeding severity.
• Evaluation of absolute indications for antiplatelet treatment versus high surgical bleeding risk.
• Referral to an expert committee for complex or extreme cases.

Main Results:

• The proposed protocol enables precise assessment of patient-specific risks.
• It facilitates informed decisions on continuing or withholding antiplatelet therapy.
• Expected to improve perioperative outcomes by reducing both bleeding and clotting events.

Conclusions:

• Implementing this protocol can optimize perioperative antiplatelet management.
• It addresses the critical balance between preventing thrombosis and surgical bleeding.
• A structured approach leads to safer surgical interventions for patients on dual antiplatelet therapy.