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British Journal of Anaesthesia 2006 96(6):675-677; doi:10.1093/bja/ael098
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Coronary stents and perioperative anti-platelet regimen: dilemma of bleeding and stent thrombosis

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The incidence of coronary artery disease (CAD) in the Western population is high and increasing. Its treatment, by coronary revascularization, was revolutionized in 1977 by Grüntzig who performed the first percutaneous transluminal coronary balloon angioplasty in Zürich, Switzerland. Nine years later the first coronary stent was deployed in Lausanne, Switzerland, by Sigwart and colleagues.1 2 Currently, over 90% of all percutaneous coronary interventions (PCIs) involve placement of stents.3

Any PCI causes trauma to the vessel wall, rendering the endoluminal surface thrombogenic4 and thus, adjunctive anti-platelet medication is a crucial element in preventing local coronary thrombosis.5 Current recommendations call for initial dual anti-platelet therapy with aspirin and clopidogrel.5–7 Aspirin is generally maintained for life. Clopidogrel treatment is recommended for at least 3–12 months depending on the type of stent implanted (6 weeks for bare . . . [Full Text of this Article]

D. R. Spahn1,*, S. J. Howell3, A. Delabays2 and P.-G. Chassot1

1 Department of Anaesthesiology, University Hospital Lausanne Lausanne, Switzerland
2 Department of Cardiology, University Hospital Lausanne Lausanne, Switzerland
3 Academic Unit of Anaesthesia, University of Leeds UK

*E-mail: donat.spahn@chuv.ch


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Pronlonging coronary stent life and balancing perioperative risk: More studies needed.
Dr Sumit Kumar Jha, et al.
British Journal of Anaesthesia, 18 May 2006 [Full text]