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

Abstract

Background:

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.

Conclusion:

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: https://creativecommons.org/licenses/by/4.0/legalcode. 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: manthosdid@yahoo.gr