Intraoperative drug-eluting stent thrombosis in a patient undergoing robotic prostatectomy.
Insertion of drug-eluting stents is one of the strategies for treating patients with coronary artery disease. These patients can be a perioperative challenge in management as they need to be maintained on antiplatelet therapy to prevent stent thrombosis, which puts them at an increased risk for surgical bleeding. Recently revised guidelines on elective surgery following insertion of a drug-eluting stent recommend dual antiplatelet therapy for a period of twelve months. The management of a patient who presented for surgery more than two years after the insertion of a drug-eluting stent, and who developed in-stent thrombosis intraoperatively, is presented.
Sharma
Aarti
A
Department of Anesthesiology, Weill Cornell Medical Center and New York Presbyterian Hospital, New York, NY 10065, USA. avs9002@med.cornell.edu
Berkeley
Abiona
A
D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004562:Electrocardiography; D017809:Fatal Outcome; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D012371:Robotics; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000209:etiology
D010975:Platelet Aggregation Inhibitors