Uneventful removal of an epidural catheter guided by impedance aggregometry in a patient with recent coronary stenting and treated with clopidogrel and acetylsalicylic acid.
OBJECTIVE
This report suggests that impedance aggregometry can be helpful to assess optimum time for and minimize the risk of catheter removal during double antiplatelet therapy.


METHODS
A 52-year-old patient undergoing cystectomy during combined general and epidural anesthesia suffered an acute myocardial infarction, and required coronary artery stenting and dual antiplatelet function therapy.


CONCLUSIONS
Balancing the risks of stent occlusion and epidural bleeding, bedside impedance aggregometry helped to identify the optimum time window for epidural catheter removal with the lowest bleeding risk in this patient.
Bergmann
Lars
L
Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Universitätsklinikum Essen, Essen, Germany. lars.bergmann@uni-essen.de
Kienbaum
Peter
P
Görlinger
Klaus
K
Peters
Jürgen
J
D015360:Analgesia, Epidural / Q000295:instrumentation*; D001241:Aspirin / Q000627:therapeutic use; D002404:Catheterization; D000077144:Clopidogrel; D015653:Cystectomy; D020878:Device Removal; D017097:Electric Impedance; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy*; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010979:Platelet Function Tests / Q000379:methods*; D011183:Postoperative Complications; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin