Late coronary stent thrombosis complicating urologic surgery.
The current practice of withdrawing antiplatelet therapy before major surgery has been challenged by the introduction of coronary drug-eluting stents (DESs) since evidence is accumulating that a DES requires dual antiplatelet therapy for at least a year. The authors present a case demonstrating difficulty in decision-making when it comes to appropriate perioperative antiplatelet therapy. The patient experienced a coronary stent thrombosis possibly due to discontinuation of clopidogrel prior to urologic surgery.
de Korte
Fleur I
FI
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
van Werkum
Jochem W
JW
Vijverberg
Peter L M
PL
Ten Berg
Jurriën M
JM
D000368:Aged; D000077144:Clopidogrel; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008197:Lymph Node Excision; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology*; D013927:Thrombosis / Q000209:etiology*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D028761:Withholding Treatment
D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D017239:Paclitaxel