Data from high-risk patients requiring early discontinuation of dual antiplatelet therapy due to non-deferrable, non-cardiac surgery show good short and long-term safety outcomes following treatment with the Genous stent (OrbusNeich), according to a study published online on the Journal Minerva Cardioangiologica.
In the single-centre study, patients treated with the Genous endothelial progenitor cell capture stent discontinued dual antiplatelet therapy between 21 and 30 days post-procedure and underwent non-cardiac surgical intervention within 60 days of percutaneous coronary intervention. Despite the shortened period of dual antiplatelet therapy administration, there were no cases of stent thrombosis observed in patients treated with Genous. Additionally, no cases of perioperative major adverse cardiac events were detected. After a mean follow-up of 15.4+/-10.3 months, two cases of cardiac death were reported, with no ischaemia-driven target lesion revascularisation observed.
“Patients in need of revascularisation and subsequent non-cardiac surgery are a significant management challenge due to their increased risk for major adverse cardiovascular events related to stent thrombosis and intra-operative bleeding,” said Paolo Scacciatella, Department of Cardiovascular and Thoracic Diseases, S. Giovanni Battista University Hospital, Turin, Italy, and lead author of the publication. “The results from this study confirm the feasibility and safety of the Genous stent in patients requiring early discontinuation of dual antiplatelet therapy as a result of non-deferrable surgical intervention. Given the lack of stent thrombosis over the long term in patients with high clinical and angiographic risk, the Genous stent represents an attractive alternative to bare metal and drug-eluting stents for these complex cases.”
The study included 26 patients who underwent percutaneous coronary intervention and 20 patients then received non-cardiac surgical intervention within 60 days of the percutaneous coronary intervention. The primary outcome of the study was the occurrence of cardiac death, myocardial infarction, stent thrombosis and major adverse events. According to the American Heart Association /American College of Cardiology (AHA/ACC) guidelines, non-cardiac surgery should be delayed by four to six weeks following percutaneous coronary intervention with a bare metal stent and one year following percutaneous coronary intervention with a drug- eluting stent.
