Head DE, Sebranek JJ, Zahed C, Coursin DB, Prielipp RC
A tale of two stents: perioperative management of patients with drug-eluting coronary stents. [Journal Article]
J Clin Anesth 2007 Aug; 19(5):386-96.
Drug-eluting stents were introduced into clinical practice to decrease coronary stent restenosis rates. Though remarkably effective in reducing this complication, recent data reveal that drug-eluting stents pose a significant risk for late stent thrombosis, an event strongly correlated with discontinuation of anti-platelet therapy. Because anti-platelet agents are often discontinued perioperatively, patients with DES are at risk for perioperative stent thrombosis and myocardial infarction. Along with a review of the recent literature, we present two cases of patients with drug-eluting stents scheduled for renal transplantation. Two distinct antithrombotic management strategies illustrate the risk of either approach-bleeding and transfusion versus stent thrombosis and myocardial infarction.
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