© 2005 by BMJ Publishing Group & British Cardiac Society
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ISCHAEMIC HEART DISEASE
Although good at reducing restenosis, drug eluting stents (DES) have not yet been shown to reduce mortality. There is a known risk to performing non-cardiac surgery soon after bare metal stenting, presumably from stent thrombosis when endothelialisation has not occurred. However, operations done after six weeks appear to be safe even when antiplatelet agents are stopped. The same may not be true for DES. Four case reports are presented with clopidogrel having been stopped safely six months after DES. However, with the aspirin being stopped > 30 days after the first procedure in preparation for non-cardiac surgery, 4–5 days later, in-stent thrombosis of the DES occurred. The cause is not clear, but presumably poor endothelialisation may play a part. Plan—keep the aspirin going if at all possible.
McFadden EP, Stabile E, Regar E, et al. Late thrombosis in drug eluting coronary stents after discontinuation of antiplatelet therapy. Lancet 2004
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