Preoperative Percutaneous Coronary Intervention Prior to Non-Cardiac Surgery: Which Patients Will Benefit?

Percutaneous coronary intervention may be one effective strategy to optimize the cardiac risk of patients scheduled for noncardiac surgery. Available studies confirm a benefit of such an intervention if the indications for preoperative testing and intervention are independent from the surgical procedure. Patients with low-and intermediaterisk procedures will not benefit. The current trend of PCI with placement of at least one stent in about 90 % of procedures results in perioperative problems. Depending on cancellation or continuation, dual antiplatelet drug therapy with clopidogrel and ASS requires careful perioperative strategies to avoid both perioperative stent thrombosis or significant surgical bleeding. Adequate pre-, intra-and postoperative management can only be achieved by close collaboration between surgeon, cardiologist, and anaesthesiologist.