Peripheral nerve block as a sole anesthetic technique in a patient with a recent history of coronary stenting: A Case Report

Abstract

Anesthesiologists often encounter patients who have recently undergone coronary artery stent implantation and are receiving dual antiplatelet therapy. Performing non-cardiac surgeries or invasive procedures shortly after stent placement heightens the risk of stent thrombosis, particularly if the intervention occurs soon after the procedure. This situation presents a clinical dilemma: whether to discontinue antiplatelet therapy to reduce bleeding risk or to maintain it to prevent perioperative stent thrombosis. An individualized management strategy is essential, incorporating the following key considerations: (i) assess patient history and stent details, including the date of stent placement, the type of stent (e.g., bare-metal or drug-eluting), and any procedural complication encountered (ii) evaluate stent-related risks(iii)collaborative decision making approach -decisions regarding surgical timing and adjustments to antiplatelet therapy, including continuation, modification, or temporary discontinuation, should be made through a multidisciplinary discussion. This collaborative and individualized approach is essential for optimizing patient safety and surgical outcomes. 1