Optimizing Dual-Antiplatelet Therapy in the Perioperative

World Neurosurg · May 2024

Review

Optimizing Dual-Antiplatelet Therapy in the Perioperative Period for Spine Surgery after Recent Percutaneous Coronary Intervention: A Comprehensive Review, Synthesis, and Catalyst for Protocol Formulation.

The increased incidence of spine surgery within the past decade has highlighted the importance of robust perioperative management to improve patient outcomes overall. Coronary artery disease is a common medical comorbidity present in the population of individuals who receive surgery for spinal pathology that is often treated with dual antiplatelet therapy (DAPT) after percutaneous coronary intervention. ⋯ We review the most recent cardiac and spine literature on the intricacies of percutaneous coronary intervention and its associated risks in the postoperative period. We further propose protocols for DAPT use after both elective and urgent spine surgery to optimize perioperative care.

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- Noelle Lucke-Wold, Grace Hey, Angela Rivera, Danyas Sarathy, Rogina Rezk, Andrew MacNeil, Ashley Albright, and Brandon Lucke-Wold.
- Malcom Randall Veteran Affairs Medical Center, Gainesville, Florida, USA.
- World Neurosurg. 2024 May 1; 185: 267278267-278.
AbstractThe increased incidence of spine surgery within the past decade has highlighted the importance of robust perioperative management to improve patient outcomes overall. Coronary artery disease is a common medical comorbidity present in the population of individuals who receive surgery for spinal pathology that is often treated with dual antiplatelet therapy (DAPT) after percutaneous coronary intervention. Discontinuation of DAPT before surgical intervention is typically indicated; however, contradictory evidence exists in the literature regarding the timing of DAPT use and discontinuation in the perioperative period. We review the most recent cardiac and spine literature on the intricacies of percutaneous coronary intervention and its associated risks in the postoperative period. We further propose protocols for DAPT use after both elective and urgent spine surgery to optimize perioperative care.Copyright © 2024 Elsevier Inc. All rights reserved.

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Optimizing Dual-Antiplatelet Therapy in the Perioperative Period for Spine Surgery after Recent Percutaneous Coronary Intervention: A Comprehensive Review, Synthesis, and Catalyst for Protocol Formulation.

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