• Nainesh K Gandhi, Abdul-Rahman R Abdel-Karim, Subhash Banerjee, and Emmanouil S Brilakis.
• VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas 75216, USA.
• Catheter Cardiovasc Interv. 2011 Jun 1;77(7):972-6.

BackgroundFew studies have described the frequency and risk of surgery after drug-eluting stent (DES) implantation.MethodsThe medical records of 827 consecutive patients who received a DES at our institution between January 1, 2005 and July 1, 2008 were retrospectively reviewed to determine the outcomes of patients who subsequently underwent noncardiac surgery.ResultsDuring a median follow-up of 21 months, 135 patients underwent 191 noncardiac surgeries. The incidence of noncardiac surgery was 7% at 1 year, 18% at 2 years, and 22% at 3 years. Mean age was 62 years and 96% were men. A perioperative complication occurred in 19 surgeries (10%): excessive bleeding in 11 patients (6%), myocardial infarction in four patients (2%), acute renal failure in one patient (0.5%), hypotension and syncope in one patient (0.5%) and postoperative death in three patients (1.6%). Stent thrombosis occurred in one patient (0.5%). A complication occurred in six of 58 surgeries (10%) in which patients received perioperative clopidogrel vs. 13 of 133 surgeries (10%) in which patients did not receive perioperative clopidogrel (P = 0.90). Complications occurred in three of 25 surgeries performed within 6 months (16%), in four of 37 surgeries performed between 6 and 12 months (11%), and in 12 of 129 surgeries performed after >12 months (9%) from DES implantation (P = 0.90).ConclusionNoncardiac surgery is frequently needed in the years after DES implantation and appears to carry a low risk of stent thrombosis and perioperative complications.Copyright © 2011 Wiley-Liss, Inc.

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