Mesh : 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

来  源:   DOI:10.1016/j.carrev.2011.08.004

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.
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