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Savonitto, S., D’Urbano, M., Caracciolo, M., Barlocco, F., Mariani, G., Nichelatti, M., Klugmann, S. and De Servi, S. (2010) Urgent surgery in patients with a recently implanted coronary drug-eluting stent: A phase II study of “bridging” antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel. British Journal of Anaesthesia, 104, 285-291. http://dx.doi.org/10.1093/bja/aep373

has been cited by the following article:

• TITLE: Coronary artery stents and surgery; the basis of sound perioperative management

  AUTHORS: Stephen Bolsin, Chin Hiew, Garth Birdsey, Mark Colson, Jessica Gillet

  KEYWORDS: Coronary Artery Stent; Thrombosis; Haemorrhage; Surgery Complication

  JOURNAL NAME: Health, Vol.5 No.10, October 28, 2013

  ABSTRACT: The introduction of drug-eluting stents (DES) to interventional cardiology heralded a limited time of increased anaesthetic and surgical complications in patients implanted with these devices. The horns of the dilemma, in the anaesthetic and surgical management of patients in the first 3-6 months after the 1st generation DES insertion, were between the risk of bleeding from continued clopidogrel treatment and the risk of instent thrombosis and myocardial infarction following discontinuation of dual antiplatelet therapy, clopidogrel and aspirin. Initial accounts of early catastrophic cardiac and haemorrhagic complications, at the time of elective or emergency surgery, following DES insertion, were followed by equally worrying reports of instent thrombosis many months after DES insertion. Initial recommendations for the conduct of safe operations were propagated in the literature before formal guidelines were produced. This article summarises the issues identified in the development of interventional cardiology particularly DES and the requirement for ongoing antiplatelet therapy. The article reviews the treatment protocols that are still applicable for the different devices that have been deployed in clinical practice.