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Post-PCI Perioperative Management — EECC MCQ

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HardCardiologyPost-PCI Perioperative ManagementEECC

A patient requires time-critical cancer surgery 24 days after left-main PCI with a drug-eluting stent. Surgery cannot safely be deferred for three months. Which approach best addresses the competing risks?

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Correct answer: D — Urgent multidisciplinary planning with continuation of aspirin where haemostasis permits

Surgery soon after complex PCI carries substantial stent-thrombosis risk, while uninterrupted dual antiplatelet therapy may make some operations unsafe. A cardiology, anaesthetic and surgical decision is needed; aspirin is usually continued when possible, and any P2Y12 interruption is minimised rather than bridged with heparin.

Reference: https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/chronic-coronary-syndromes/