Study Supports Loosening Guidelines for Surgery After Stent Implantation

According to current guidelines, noncardiac surgery should be delayed for six weeks after bare-metal stent (BMS) implantation and for one year after drug-eluting stent (DES) implantation, though there is little good evidence to support these recommendations. Stent thrombosis caused by discontinuation of antiplatelet therapy in order to lower the risk of bleeding during surgery is the biggest concern. Now, a new study published in JAMA suggests that the guidelines may be over strict and that delays recommended after DES implantation are longer than warranted.

Mary T. Hawn and colleagues analyzed data from nearly 125,000 VA patients who received a stent between 2000 and 2010. Within this group more than 28,000 (22.5%) had a noncardiac operation within 2 years…

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