Bridging with Tirofiban During Temporary Withdrawal of Oral Antiplatelets for Two Major Surgical Procedures in High Ischaemic Risk Patients

Maria Vlachou, Matthaios Didagelos, Antonios Kouparanis, Haralambos Karvounis, Antonios Ziakas*
IstCardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece



Recent coronary stent implantation requires dual antiplatelet therapy (DAPT) for at least 6 months. Serious issues are raised when non-cardiac surgery is required during this period, because of the balance between ischaemic and haemorrhagic complications.

Case reports:

We report 2 high ischemic risk cases requiring intermediate bleeding risk non-cardiac surgery, during the first month of DAPT initiation. Perioperative management with discontinuation of the P2Y12 inhibitor and bridging with tirofiban, while aspirin was uninterrupted, was uneventful.


Bridging with intravenous glycoprotein IIb/IIIa receptor inhibitors may be a safe and effective alternative to P2Y12 inhibitor discontinuation in non-deferrable non-cardiac surgery.

Keywords: Tirofiban, Dual Antiplatelet Therapy, Acute Coronary Syndrome, Cardiac Ischemic Complications.

Abstract Information

Identifiers and Pagination:

Year: 2018
Volume: 12
Publisher Item Identifier: EA-TOCMJ-2018-21

Article History:

Received Date: 31/8/2018
Revision Received Date: 10/10/2018
Acceptance Date: 19/10/2018
Electronic publication date: 29/10/2018
Collection year: 2018

© 2018 Vlachou et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the IstCardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece, St. Kyriakidi 1, P.C.: 54636, Thessaloniki, Greece; Tel: +306942488823; Fax: +302310994837; E-mail: