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
