Cangrelor Monotherapy Bridging for Cardiac and Non-Cardiac Surgery Following Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Pharmacology
• Surgical Management

Background:

• Perioperative dual antiplatelet therapy (DAPT) management is critical for patients with recent percutaneous coronary intervention (PCI).
• High bleeding risk patients present unique challenges in balancing thrombotic and bleeding complications.
• Intravenous antiplatelet agents are often considered for bridging therapy.

Observation:

• This case series details the perioperative care of two patients with recent PCI and high bleeding risk.
• Both patients underwent major cardiac and non-cardiac surgeries.
• Cangrelor monotherapy was utilized for perioperative anticoagulation management.

Findings:

• Successful perioperative management was achieved using cangrelor monotherapy in both high-risk patients.
• This approach facilitated surgical procedures while mitigating thrombotic events.
• No major bleeding complications were reported in the described cases.

Implications:

• Cangrelor monotherapy may represent a viable strategy for managing DAPT in select high-bleeding-risk patients undergoing surgery after recent PCI.
• Further research is warranted to establish optimal protocols for cangrelor use in this population.
• This case series contributes to the understanding of perioperative antiplatelet strategies in complex cardiovascular patients.