Consequences of coronary artery stenting for non‐cardiac surgery

Abstract

SUMMARYPercutaneous coronary intervention with intracoronary stenting is a routine procedure in the treatment of coronary artery disease today. While complication rates of in‐stent stenosis and thromboembolic complications dropped over the years due to improved stent design, material, coating and consequent antiplatelet medication, major concerns remain relating to non‐cardiac surgery following briefly after coronary artery stent implantation. A mortality rate of almost 5% has to be expected in a mixed surgical and orthopedic population after coronary artery stenting. Data about cardiac surgery briefly after stent implantation are not available. The risk of major bleeding following continued perioperative antiplatelet therapy has to be balanced against the risk of stent thrombosis by discontinuation of antiplatelet medication in these patients. The careless withdrawal of antiplatelet therapy preoperatively must be avoided.