[Bleeding or stent thrombosis in combination with drug-eluting stents]

Abstract

Prolonged antiplatelet therapy with clopidogrel is mandatory after implantation of drug-eluting stents. Evidence to support recommendations as to whether or not the treatment should be discontinued before an operation is lacking. We describe two cases in which clopidogrel was discontinued preoperatively with severe consequences (one fatality). Awaiting scientific evidence, anaesthetists, surgeons and cardiologists should establish local treatment algorithms for the management of surgical patients with a drug-eluting stent.