Bridging therapy after recent stent implantation: case report and review of data.

Abstract

For patients requiring surgery within their first year following coronary stent placement, maximizing the prevention of stent thrombosis with antiplatelet therapy while minimizing the risk of intraoperative bleeding has become a management challenge for cardiologists, surgeons and anesthesiologists. In this manuscript, we describe a case of a patient who received three stents (two of which were drug-eluting) and 7 months later was bridged with intravenous eptifibatide, a short-acting glycoprotein (GP) IIb/IIIa inhibitor, for 3 days prior to bronchoscopy and cervical mediastinoscopy for a suspected lung cancer. We then review the current literature for data and guidelines describing the use of short-acting GP IIb/IIIa as bridge therapy. Finally, we provide recommendations, based on our experience combined with this review, for bridge therapy in the perioperative period for patients with recent coronary stents.

• Authors: Jeffrey D Wessler, Fidencio Saldana, Robert P Giugliano
• Journal: Cardiovascular revascularization medicine : including molecular interventions (Cardiovasc Revasc Med) 2012 Jan-Feb Vol. 13 Issue 1 Pg. 30-8 ISSN: 1878-0938 [Electronic] United States
• PMID: 22019210 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Peptides
• Platelet Aggregation Inhibitors
• Platelet Glycoprotein GPIIb-IIIa Complex
• Eptifibatide

Topics

• Aged
• Anticoagulants (therapeutic use)
• Drug-Eluting Stents (adverse effects)
• Eptifibatide
• Humans
• Male
• Peptides (therapeutic use)
• Perioperative Care
• Platelet Aggregation Inhibitors (therapeutic use)
• Platelet Glycoprotein GPIIb-IIIa Complex (therapeutic use)
• Stents (adverse effects)
• Thrombosis (etiology, prevention & control)