title: A tale of two stents: perioperative management of patients with drug-eluting coronary stents.
abstract: Drug-eluting stents were introduced into clinical practice to decrease coronary stent restenosis rates. Though remarkably effective in reducing this complication, recent data reveal that drug-eluting stents pose a significant risk for late stent thrombosis, an event strongly correlated with discontinuation of anti-platelet therapy. Because anti-platelet agents are often discontinued perioperatively, patients with DES are at risk for perioperative stent thrombosis and myocardial infarction. Along with a review of the recent literature, we present two cases of patients with drug-eluting stents scheduled for renal transplantation. Two distinct antithrombotic management strategies illustrate the risk of either approach-bleeding and transfusion versus stent thrombosis and myocardial infarction.
authors.affiliation: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. dehead@wisc.edu
authors.forename: Diane E
authors.initials: DE
authors.lastname: Head
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Sebranek
authors.forename: Cameron
authors.initials: C
authors.lastname: Zahed
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Coursin
authors.forename: Richard C
authors.initials: RC
authors.lastname: Prielipp
mesh_terms: D000465:Algorithms; D023921:Coronary Stenosis / Q000209:etiology / Q000517:prevention & control*; D003328:Coronary Thrombosis / Q000188:drug therapy / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D013997:Time Factors