Perioperative in-stent thrombosis after lung resection performed within 3 months of coronary stenting.
BACKGROUND
Incidence of perioperative in-stent thrombosis associated with myocardial infarction in patients undergoing major lung resection within 3 months of coronary stenting.


METHODS
Retrospective multi-institutional trial including all patients undergoing major lung resection (lobectomy or pneumonectomy) within 3 months of coronary stenting with non-drug-eluting stents between 1999 and 2004.


RESULTS
There were 32 patients (29 men and 3 women), with age ranging from 46 to 82 years. One, two or four coronary stents were deployed in 72%, 22% and 6% of the patients, respectively. The time intervals between stenting and lung surgery were <30 days, 30-60 days and 61-90 days in 22%, 53% and 25% of the patients, respectively. All patients had dual antiplatelet therapy after stenting. Perioperative medication consisted of heparin alone or heparin plus aspirin in 34% and 66% of the patients, respectively. Perioperative in-stent thrombosis with myocardial infarction occurred in three patients (9%) with fatal outcome in one (3%). Twenty patients underwent lung resection after 4 weeks of dual antiplatelet therapy as recommended by the ACC/AHA Guideline Update; however, two out of three perioperative in-stent thrombosis occurred in this group of patients.


CONCLUSIONS
Major lung resection performed within 3 months of coronary stenting may be complicated by perioperative in-stent thrombosis despite 4 weeks of dual antiplatelet therapy after stenting as recommended by the ACC/AHA Guideline Update.
Brichon
Pierre-Yves
PY
Department of Thoracic Surgery, Centre Hospitalier Universitaire Grenoble, France.
Boitet
Philippe
P
Dujon
Antoine
A
Mouroux
Jerôme
J
Peillon
Christophe
C
Riquet
Marc
M
Velly
Jean-Francois
JF
Ris
Hans-Beat
HB
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D003327:Coronary Disease / Q000601:surgery*; D003328:Coronary Thrombosis / Q000209:etiology* / Q000517:prevention & control; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011013:Pneumonectomy; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D015607:Stents
D010975:Platelet Aggregation Inhibitors