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Chapter-11 Perioperative Guidelines for Patients with Coronary Artery Stents

BOOK TITLE: Practice Guidelines in Anesthesia-2

Author
1. Mehta Yatin
2. Nambiar Prajeesh M
ISBN
9789352703067
DOI
10.5005/jp/books/14207_12
Edition
1/e
Publishing Year
2018
Pages
7
Author Affiliations
1. ISCCM; Medanta Institute of Critical Care and Anesthesiology, Medanta–The Medicity, Gurugram, Haryana, India, Institute of Critical Care and Anesthesia, Medanta—The Medicity, Gurugram, Haryana, India, Medanta Institute of Critical Care and Anesthesiology, Medanta—The Medicity, Gurugram, Haryana, India, Institute of Critical Care Anesthesiology, Medanta —The Medicity, Gurugram, Haryana, India, NBE; ISCCM; Medanta Institute of Critical Care and Anesthesiology; Medanta—The Medicity, Gurugram, Haryana, India, Medanta—The Medicity, Gurugram, Haryana, India, Medanta Institute of Critical Care and Anesthesiology, Medanta–The Medicity, Gurugram, Haryana, India, Medanta Institute of Critical Care and Anesthesiology, Medanta—The Medicity, Gurugram, Haryana, India, The Simulation Society (TSS); Medanta—The Medicity, Gurugram, Haryana, India, Medanta – The Medicity, Gurugram, Haryana, India
2. Medanta Institute of Critical Care and Anesthesiology, Medanta—The Medicity, Gurugram, Haryana, India, Baby Memorial Hospital Pvt Ltd, Calicut, Kerala, India
Chapter keywords
Coronary artery stent, coronary artery disease, fractional flow reserve, FFR, intravascular ultrasound, IVUS, bare metal stent, BMS, drug eluting stent, DES

Abstract

This chapter describes perioperative guidelines for patients with coronary artery stents. Coronary artery disease has led to epidemic proportions worldwide with an estimated global mortality of 17.5 million in 2012, with more than 75% of these deaths occurring in developing countries. The various method of assessing the stent functionality post PCI are angiographic appearance (most commonly used), fractional flow reserve (FFR), intravascular ultrasound (IVUS), and optical coherence tomography. Types of stents are bare metal stents (BMS) and drug eluting stents (DES). BMS are made of stainless steel or chromium, with the stainless steel stents being the first ones used for PCI. Drug eluting stents were designed to prevent the restenosis seen with a BMS. This chapter also covers the second generation DES and antiplatelet therapy post PCI and perioperative management.

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