A new approach to percutaneous coronary revascularization in patients requiring undeferrable non-cardiac surgery.
BACKGROUND
Optimal strategy for patients who need coronary revascularization before undeferrable non-cardiac surgery is still unknown. We performed a pilot study of dual antiplatelet therapy discontinuation followed by major non-cardiac surgery and endovascular aortic repair early after successful endothelial-progenitor cell-capture coronary stent deployment.


RESULTS
Thirty consecutive patients underwent coronary angioplasty plus stenting, before upcoming endovascular or surgical procedures requiring early interruption of antiplatelet therapy. An optimal acute procedural result was observed in all patients. Antiplatelet therapy was stopped before surgery in all patients, achieving an average antiplatelet therapy time of 12.2 ± 3.9 days. Surgery was performed after antiplatelet therapy interruption at an average time interval from revascularization of 17.2 ± 3.9 days. No patient suffered cardiac events during the perioperative period. At thirty day follow-up after surgery there were no cardiac events in all patients.


CONCLUSIONS
Our preliminary data might suggest a role for EPC-capture stent in patients requiring surgical procedures early after coronary stent placement. Further studies on larger population are needed to confirm the clinical impact of our findings.
Piscione
Federico
F
Department of Clinical Medicine, Cardiovascular Science and Immunology, Federico II University, Naples, Italy. piscione@unina.it
Cassese
Salvatore
S
Galasso
Gennaro
G
Cirillo
Plinio
P
Esposito
Giovanni
G
Rapacciuolo
Antonio
A
Leosco
Dario
D
Piccolo
Raffaele
R
De Rosa
Roberta
R
Chiariello
Massimo
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015607:Stents; D013514:Surgical Procedures, Operative
D010975:Platelet Aggregation Inhibitors