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Editorial |

Patient With Coronary Stents Needs Surgery:  What to Do?

Emmanouil S. Brilakis, MD, PhD1; Subhash Banerjee, MD1
[+] Author Affiliations
1VA North Texas Health Care System, University of Texas Southwestern Medical Center at Dallas
JAMA. 2013;310(14):1451-1452. doi:10.1001/jama.2013.279123.
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One of the most common questions interventional cardiologists are being asked is: “My patient needs surgery and has a coronary stent; should I clear him/her for surgery and what should I do about the antiplatelet therapy?” With approximately 1 in 5 patients undergoing noncardiac surgery within 2 years after receiving a stent,1 this will continue to be a frequent question in the years to come.

The fact that this question is being asked is encouraging and reflects that most physicians are aware of the possibility of perioperative stent thrombosis, a severe and sometimes life-threatening complication that can occur when patients with coronary stents undergo surgery.2 Perioperative stent thrombosis is the result of several factors, such as incomplete stent endothelialization, antiplatelet therapy discontinuation, and the prothrombotic state caused by surgery, and carries significant morbidity and mortality.2

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