[Bleeding or stent thrombosis in combination with drug-eluting stents].
Prolonged antiplatelet therapy with clopidogrel is mandatory after implantation of drug-eluting stents. Evidence to support recommendations as to whether or not the treatment should be discontinued before an operation is lacking. We describe two cases in which clopidogrel was discontinued preoperatively with severe consequences (one fatality). Awaiting scientific evidence, anaesthetists, surgeons and cardiologists should establish local treatment algorithms for the management of surgical patients with a drug-eluting stent.
Jensen
Marianne Kjaer
MK
Anaestesiologisk og Intensiv Afdeling V, Odense Universitetshospital, DK-5000 Odense C. marianne.kjaer@ouh.regionsyddanmark.dk
Hüttel
Mogens
M
D017541:Aneurysm, False / Q000601:surgery; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D016063:Blood Loss, Surgical; D000077144:Clopidogrel; D001026:Coronary Artery Bypass; D054855:Drug-Eluting Stents / Q000009:adverse effects; D017809:Fatal Outcome; D006119:Groin; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin