{Reference Type}: Journal Article
{Title}: The perioperative management of patients with coronary artery stents: surveying the clinical stakeholders and arriving at a consensus regarding optimal care.
{Author}: Vetter TR;Boudreaux AM;Papapietro SE;Smith PW;Taylor BB;Porterfield JR;
{Journal}: Am J Surg
{Volume}: 204
{Issue}: 4
{Year}: Oct 2012
{Factor}: 3.125
{DOI}: 10.1016/j.amjsurg.2012.02.012
{Abstract}: <B>BACKGROUND: </B>The perioperative management of patients with a coronary artery stent is a major patient safety issue currently confronting clinicians. Surgery on a patient on antiplatelet therapy creates the following dilemma: is it better to withdraw the drugs and reduce the hemorrhagic risk or to maintain them and reduce the risk of a myocardial ischemic event?<BR><B>METHODS: </B>An electronic survey was used to sample a cross-section of local clinicians regarding the perioperative management of patients with an indwelling coronary artery stent. The reiterative Consensus-Oriented Decision-Making model was applied by an institutional task force with representation from anesthesiology, cardiology, primary care medicine, and surgery.<BR><B>RESULTS: </B>Significant disagreement existed among the multidisciplinary survey respondents regarding various aspects of the perioperative management of patients with indwelling coronary artery stents.<BR><B>CONCLUSIONS: </B>We clarified the perioperative risk factors for coronary stent thrombosis and an alternate process for immediate access to a cardiac catheterization laboratory at our institution.