Llau, Juan VFerrandis, RaquelSierra, PilarGómez Luque, Aurelio2013-03-122013-03-122010Llau JV, Ferrandis R, Sierra P, Gómez-Luque A. Prevention of the renarrowing of coronary arteries using drug-eluting stents in the perioperative period: an update. Vasc Health Risk Manag; 6:855-671176-6344http://hdl.handle.net/10668/819Journal Article; Review;The management of patients scheduled for surgery with a coronary stent, and receiving 1 or more antiplatelet drugs, has many controversies. The premature discontinuation of antiplatelet drugs substantially increases the risk of stent thrombosis (ST), myocardial infarction, and cardiac death, and surgery under an altered platelet function could also lead to an increased risk of bleeding in the perioperative period. Because of the conflict in the recommendations, this article reviews the current antiplatelet protocols after positioning a coronary stent, the evidence of increased risk of ST associated with the withdrawal of antiplatelet drugs and increased bleeding risk associated with its maintenance, the different perioperative antiplatelet protocols when patients are scheduled for surgery or need an urgent operation, and the therapeutic options if excessive bleeding occurs.enstent thrombosisantiplatelet agentsaspirinclopidogrelsurgical bleedingperioperative managementPérdida de Sangre QuirúrgicaTrombosis CoronariaStents Liberadores de FármacosHumanosRevascularización MiocárdicaAtención PerioperativaPeriodo PerioperatorioPiperazinasInhibidores de Agregación PlaquetariaTiofenosTiclopidinaAspirinaMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage::Blood Loss, SurgicalMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Coronary Disease::Coronary ThrombosisMedical Subject Headings::Anatomy::Cardiovascular System::Blood Vessels::Arteries::Coronary VesselsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Equipment and Supplies::Prostheses and Implants::Stents::Drug-Eluting StentsMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Cardiac Surgical Procedures::Myocardial RevascularizationMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Perioperative CareMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Perioperative PeriodMedical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::PiperazinesMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Platelet Aggregation InhibitorsMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Sulfur Compounds::ThiophenesMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Sulfur Compounds::Thiophenes::Thienopyridines::TiclopidineMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols::Hydroxybenzoates::Salicylates::Aspirinresearch article20957131open access10.2147/VHRM.S74021178-2048