Journal
BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY
Volume 21, Issue 2, Pages 241-256Publisher
ELSEVIER
DOI: 10.1016/j.bpa.2007.02.002
Keywords
anti-platelet therapy; non-cardiac surgery; coronary stent thrombosis; surgical haemorrhage
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Performing a surgical procedure on a patient undergoing anti-platelet therapy raises a dilemma: is it safer to withdraw the drugs and reduce the haemorrhagic risk, or to maintain them and reduce the risk of myocardial ischaemic events? Based on recent clinical data, this review concludes that the risk of coronary thrombosis on anti-platelet drugs withdrawal is much higher than the risk of surgical bleeding when maintaining them. In secondary prevention, aspirin is a lifelong therapy and should never be stopped. Clopidogrel is mandatory as long as the coronary stents are not fully endothelialized, which takes 6-24 weeks depending on the technique used, but might be required for a longer period.
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