Abstract

Perioperative management of antiplatelet treatment in patients with coronary stents remains challenging as premature discontinuation may cause thrombotic events. To date, there is a lack of evidence-based results and guidelines to recommend adequate antithrombotic drug therapy in patients at high risk of stent thrombosis who undergo noncardiac surgery. According to our clinical experience with these patients, we propose a perioperative bridging of discontinued dual antiplatelet therapy by the „off-label“ use of low molecular weight glycoprotein IIbIIIa antagonist for up to 24 hours. Patients should be monitored by a perioperative point-of-care-testing and, thus, could benefit from the individually adapted antiplatelet therapeutic issue.

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