Stent nu ou actif: quelle difference ?

摘要

More and more patients are treated for coronary artery disease through percutaneous stent implantation, with a mandatory long-term antiplate-let therapy that is a common difficulty when a surgical procedure has to be performed. There are two different types of stents: bare metal stent and drug-eluting stent. Drug-eluting stents are coated with anti-proliferative agent that decrease the risk of stent obstruction. Following a stent implantation, an antiplatelet therapy allows protection from stent clotting during the period for stent epithelialization. Thus, a double antiplatelet therapy with aspirin and clopidrogel is prescribed for a period of 6 weeks in case of bare metal stent, and for a period of I year in case of drug-eluting stent. Protective treatment should not be stopped during these periods of time in order to prevent stent thrombosis and coronary obstruction, particularly for drug-eluting stents where this risk is even higher. Every antiplatelet therapy interruption in these patients before surgery should be discussed by cardiologist, surgeon and anaes-thesiologist, for bleeding risk vs. thrombotic risk evaluation.