Perioperative procedures in patients with implanted drug-eluting stents

Abstract

Considering the fact that the majority of stents implanted during percutaneous coronary intervention are drug-eluting stents (DES) and 5–25% of patients require a non-cardiac surgery within 5 years of implanting the stent, appropriate therapeutic procedures in the perioperative period are clinically significant. To prevent late thrombosis in patients with implanted DES, it is recommended to prolong — compared to implantation of bare metal stents — dual antiplatelet therapy. In the perioperative period, it is crucial to maintain balance between the risk of a potentially fatal haemorrhage and stent thrombosis. Taking into account the fact that premature cessation of dual antiplatelet therapy is the most significant risk factor of stent thrombosis, correct perioperative actions in patients with high risk of bleeding may present many clinical difficulties. In the study, factors that impact the risk of thrombosis and haemorrhage, as well as up-to-date guidelines and methods regarding the perioperative period procedures in patients with implanted DES have been presented.