Protocol For A Perioperative Approach To Patients With Coronary Stents Undergoing Non Cardiac Surgery.

ABSTRACT

Patients undergoing angioplasty and stent insertion require double prophylactic anti-aggregation or monotherapy. This is a challenging procedure with a high risk of morbidity and coronary mortality. The aim of this protocol is to provide guidelines for a presurgical approach to patients with a coronary stent who will be undergoing non-coronary surgery. This protocol highlights potential complications that may occur, namely those related with the cardiac stent and the evaluation of cardiac risk, and notes the thrombotic and hemorrhagic risks associated with the surgical procedure and the decision algorithms for both elective surgery and urgent surgery involving the suspension and re-introduction of antiplatelet therapy. Our main goal is to outline an optimized approach to these cases in order to improve cardiac outcomes and to minimize the risk of complications.