Coronary stents and noncardiac surgery: current clinical challenges and conundrums.
This article discusses how perioperative physicians are currently faced with unique challenges when providing care for surgical patients who have undergone recent percutaneous transluminal coronary angioplasty with drug-eluting stent (DES) placement. Despite adhering to the currently recommended antiplatelet regimens, these patients may still be at risk for sustaining a myocardial infarction secondary to stent thrombosis during the perioperative period. Given the high morbidity and mortality rates associated with perioperative myocardial infarction, it is important that the perioperative care of surgical patients with previous DES placement should be discussed, evaluated, and clarified by all practitioners who may be involved in their care.
Heir
Jagtar S
JS
Department of Anesthesiology and Perioperative Medicine, The University of Texas M D Anderson Cancer Center, Houston, TX, USA. jsheir@mdanderson.org
Gottumukkala
Vijaya
V
Singh
Manmeet
M
Yusuf
Syed Wamique
SW
Riedel
Bernhard
B
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D023921:Coronary Stenosis / Q000517:prevention & control; D054855:Drug-Eluting Stents; D006801:Humans; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors