Perioperative primary stroke: is aspirin cessation to blame?
BACKGROUND
There are a number of reports in the literature of patients developing thrombotic events after stopping medically necessary antiplatelet and antithrombotic agents.


OBJECTIVE
The objective was to determine whether discontinuation of aspirin taken for primary prophylaxis contributes to the development of thrombotic complications in patients undergoing dermatologic surgery.


METHODS
A case is reported and the literature is reviewed.


RESULTS
We present the first reported case of a postoperative thrombotic event following dermatologic surgery in a patient withholding aspirin that was taken for primary prophylaxis.


CONCLUSIONS
We believe that the available data make it difficult to implicate aspirin discontinuation in the development of each thrombotic event, given the high baseline risk of thrombotic events in the Mohs surgery patient population and the low risk of developing such events when medications are withheld perioperatively.
Kimyai-Asadi
Arash
A
DermSurgery Associates, Houston, Texas 77030, USA. akimyai@yahoo.com
Jih
Ming H
MH
Goldberg
Leonard H
LH
D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D015580:Mohs Surgery / Q000379:methods*; D009666:Nose; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000175:diagnosis; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin