title: The avantgarde carbostent in patients scheduled for undelayable noncardiac surgery.
abstract: Background. Treatment of patients who need coronary revascularization before undelayable non-cardiac surgery is challenging. Methods. We assessed the safety and efficacy of percutaneous coronary interventions (PCI) using the Avantgarde( TM) Carbostent (CID, Italy) in patients undergoing PCI before undelayable non-cardiac surgery. The Multiplate analyzer point-of-care was used to assess residual platelet reactivity. One major cardiac events (MACE, defined as death, myocardial infarction, and stent thrombosis and major bleeding) were assessed. Results. 42 consecutive patients were analyzed. Total stent length ≥25 mm was observed in 16 (37%) patients. Multivessel stenting was performed in 11 (31.5%) patients. Clopidogrel was interrupted 5 days before surgery in 35 patients, whereas it was stopped the day of the surgery in 7 patients. Surgery was performed after 27 ± 9 (7-42) days from PCI. MACE occurred in one patient (2.4%; 95% confidence interval: 0.01-13%), who had fatal acute myocardial infarction 3 days after abdominal aortic aneurysm surgery and 12 days after stent implantation. No case of major bleeding in the postoperative phase was observed. Conclusions. The present pilot study suggests that, although at least 10-14 days of dual antiplatelet therapy remain mandatory, the Avantgarde( TM) stent seems to have a role in patients requiring undelayable surgery.
authors.affiliation: Laboratory of Interventional Cardiology, Department of Cardiology, Clinica Mediterranea, Via Orazio 2, 80121 Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
authors.forename: Gabriella
authors.initials: G
authors.lastname: Visconti
authors.forename: Francesca
authors.initials: F
authors.lastname: De Micco
authors.forename: Amelia
authors.initials: A
authors.lastname: Focaccio