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Perioperative Cardiovascular Evaluation

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9 Figure 2. Algorithm for Antiplatelet Management in Patients With PCI and Noncardiac Surgery Patient With Coronary Stent Stent implantation ≤4-6 wk Delay surgery until aer optimal period (BMS: 30 d and DES 365 d) (Class I) NO DES ≥30 d, but ≤365 d a Continue DAPT unless risk of bleeding is greater than risk of stent thrombosis (Class I) NO Risk of surgical delay is greater than risk of DES thrombosis Elective surgery YES Proceed to surgery aer 180 d (Class IIb) Delay surgery until aer optimal period (BMS: 30 d and DES: 365 d) (Class I) NO Does surgery demand discontinuation P2Y 12 inhibitors? YES NO Continue current DAPT regimen Continue ASA and restart P2Y 12 ASAP (Class I) YES NO a Assuming patient is currently on DAPT. YES YES

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