Masui. The Japanese journal of anesthesiology · 2014
[Perioperative management and postoperative complication rates of patients on dual antiplatelet therapies after coronary drug eluting stent implantation].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Komiya Ryosuke, Kamintani Kazuo, Kubo Emi, Hattori Mizuki, Kataoka Hisashi, Iwase Yasuko, Miyoshi Harumi, Minami Masami, Kato Susumu, Arai Riho, Yoshida Hitoshi
Аннотация
BACKGROUND: Few studies have examined the perioperative status of dual antiplatelet therapy and postoperative thrombotic or bleeding complication rates of patients undergoing non-cardiac surgery with recent history of coronary stent implantation.
METHODS: Eight patients underwent surgery with antiplatelet therapy discontinued on both pre- and post-operative period (pre/postop group); 7 patients with only post-operative discontinuation (postop group); and 2 patients with therapy maintained (maintained group). All patients had history of coronary drug eluting stent implantation within 12 months of surgery.
RESULTS: Antiplatelets were discontinued 7 days before surgery and restarted on postoperative day 7 for the pre/postop group, and on postoperative day 5 for postop group. Re-exploration due to bleeding complication was required in 1 patient in the postop group. Two or more units of red cell concentrate transfusion were required in 2 pre/postop, 3 postop, and 1 maintained group patients intraoperatively. No cardiac thrombotic complications including in-hospital stent thrombosis were observed, in line with previous reports of low stent thrombosis rates in Asian patients.
CONCLUSIONS: In the present study, bleeding complications requiring transfusion were frequently observed in patients with dual antiplatelet therapy undergoing non-cardiac surgery, whereas perioperative therapy discontinuation did not trigger thrombotic complications including stent thrombosis.
METHODS: Eight patients underwent surgery with antiplatelet therapy discontinued on both pre- and post-operative period (pre/postop group); 7 patients with only post-operative discontinuation (postop group); and 2 patients with therapy maintained (maintained group). All patients had history of coronary drug eluting stent implantation within 12 months of surgery.
RESULTS: Antiplatelets were discontinued 7 days before surgery and restarted on postoperative day 7 for the pre/postop group, and on postoperative day 5 for postop group. Re-exploration due to bleeding complication was required in 1 patient in the postop group. Two or more units of red cell concentrate transfusion were required in 2 pre/postop, 3 postop, and 1 maintained group patients intraoperatively. No cardiac thrombotic complications including in-hospital stent thrombosis were observed, in line with previous reports of low stent thrombosis rates in Asian patients.
CONCLUSIONS: In the present study, bleeding complications requiring transfusion were frequently observed in patients with dual antiplatelet therapy undergoing non-cardiac surgery, whereas perioperative therapy discontinuation did not trigger thrombotic complications including stent thrombosis.