Coronary stent management in elective genitourinary surgery

Angela D. Gupta, Michael Streiff, Jon Resar, Mark P. Schoenberg

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

To review the literature on coronary stents and genitourinary surgery and provide a protocol for perioperative. The keywords, 'elective surgery', 'aspirin', 'clopidogrel', 'guidelines for percutaneous coronary intervention', and 'antiplatelet therapy after coronary stent placement' were used to search PubMed for any relevant articles relating to coronary stents. Recommendations were made based on the whether the procedures patients were exposed to placed them at low-, moderate- or high-bleeding risk based on the extent of the procedure. All elective procedures should be delayed for 1 month after bare-metal stent placement and 1 year after drug-eluting stent placement. In patients classified as low risk (endoscopy and laser prostatectomy), aspirin should be continued throughout the perioperative period and dual antiplatelet therapy should continue 24-48 h postoperatively, if there is no concern for active bleeding. In those classified as moderate risk (scrotal procedures, transurethral resection of bladder tumours, transurethral resection of the prostate, urinary sphincter placement) dual antiplatelet therapy should be discontinued 5-7 days before the procedure and continued within 7 days after procedure, if there is no concern for active bleeding, in consultation with cardiology. In high-risk procedures (cystectomy, nephrectomy, prostatectomy, penile prosthesis placement) dual antiplatelet therapy should be discontinued 10 days before the procedure and continued postoperatively within 7-10 days of the procedure, when there is no longer a concern for active bleeding with the assistance of a cardiologist. Coronary artery disease is becoming more prominent in our society, increasing the use of coronary stents and antiplatelet agents. With the proposed protocol, it is safe to proceed with surgical intervention in those that have adequate stent endothelialisation.

Original languageEnglish (US)
Pages (from-to)480-484
Number of pages5
JournalBJU International
Volume110
Issue number4
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Stents
Hemorrhage
clopidogrel
Prostatectomy
Aspirin
Penile Prosthesis
Transurethral Resection of Prostate
Perioperative Period
Drug-Eluting Stents
Cystectomy
Platelet Aggregation Inhibitors
Percutaneous Coronary Intervention
Therapeutics
Cardiology
Nephrectomy
PubMed
Urinary Bladder Neoplasms
Endoscopy
Coronary Artery Disease
Lasers

Keywords

  • antiplatelet
  • aspirin
  • clopidogrel
  • coronary stent
  • elective surgery

ASJC Scopus subject areas

  • Urology

Cite this

Coronary stent management in elective genitourinary surgery. / Gupta, Angela D.; Streiff, Michael; Resar, Jon; Schoenberg, Mark P.

In: BJU International, Vol. 110, No. 4, 08.2012, p. 480-484.

Research output: Contribution to journalArticle

Gupta, Angela D. ; Streiff, Michael ; Resar, Jon ; Schoenberg, Mark P. / Coronary stent management in elective genitourinary surgery. In: BJU International. 2012 ; Vol. 110, No. 4. pp. 480-484.
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