Abstract
Background: Recent coronary stent implantation requires Dual Antiplatelet Therapy (DAPT) for at least 6 months. Serious issues are raised when non-cardiac surgery is required during this period, because of the balance between ischemic and haemorrhagic complications. Case Reports: We report 2 high ischemic risk cases requiring intermediate bleeding risk non-cardiac surgery, during the first month of DAPT initiation. Perioperative management with discontinuation of the P2Y12 inhibitor and bridging with tirofiban, while aspirin was uninterrupted, was uneventful. Conclusion: Bridging with intravenous glycoprotein IIb/IIIa receptor inhibitors may be a safe and effective alternative to P2Y12 inhibitor discontinuation in non-deferrable non-cardiac surgery.
Highlights
The European Society of Cardiology (ESC) Guidelines recommend Dual Antiplatelet Therapy (DAPT) using aspirin and a P2Y12 receptor inhibitor for 6 months, following an Acute Coronary Syndrome (ACS) with coronary stent implantation
We present 2 cases of patients who were on DAPT after an
The histological examination was positive for a colon adenocarcinoma in the first patient and a pulmonary adenocarcinoma in the second one. Both patients were discharged on DAPT and haemodynamically stable, without any cardiac ischaemic complications after a follow-up of 6 months
Summary
Bridging with intravenous glycoprotein IIb/IIIa receptor inhibitors may be a safe and effective alternative to P2Y12 inhibitor discontinuation in non-deferrable non-cardiac surgery.
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