Surgery after drug-eluting stent implantation: it's not all doom and gloom!

Journal of Thoracic Disease
Francesco Saia

Abstract

Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment. Perioperative pharmacologic management in those patients is intricate because of the tradeoff between the increased thrombotic risk associated with premature DAPT discontinuation and the increased risk of bleeding in the presence of antithrombotics. Whilst most of the studies agree upon the inverse relationship between time from stenting to surgery and cardiac risk, more recent data challenge the previous belief that surgery should be deferred at least 12 months after DES implantation and this safety window could be shortened to <6 months or even less with new-generation DES. The aim of this brief commentary is to critically review available data about cardiac risk associated wit...Continue Reading

Citations

Apr 25, 2019·The Journal of International Medical Research·Sheng-Gang ZhaoLi-Qin Jiang
Jul 20, 2020·The Journal of Surgical Research·Tak Kyu OhIn-Ae Song
Aug 20, 2021·Cardiovascular Engineering and Technology·Omer Burak Istanbullu, Gulsen Akdogan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.