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Oct 18, 2013

Is Surgery Safe for Stent Patients?

Study suggests that patients with stents should wait six months to undergo elective surgery to reduce risk of complications.

Having a stent can increase risk of complications from surgery, especially when an operation is performed soon after the initial stent procedure. So when is it safe for patients with stents to have an operation? According to a recent study, waiting at least six months to undergo surgery after receiving a stent may help significantly reduce risk of complications.

This study used the Veterans Affairs electronic medical record system to identify stent patients that underwent surgery between 2000 and 2010. Among nearly 42,000 operations taking place within two years of a stent procedure, the risk of serious complications was 4.7%. However, risk of complications steadily decreased as more time passed between the stent procedure and surgery. Risk of complications from surgery within six weeks of receiving a stent was nearly 12% while risk was only 4.2% a year or more after a stent procedure. Not surprisingly, risk of complications was highest for patients who underwent emergency surgery or were at increased cardiovascular risk.

Overall, these findings confirm what other studies have demonstrated—that risk of complications from surgery decreases with time. But compared to current guidelines recommending that patients with bare metal stents wait six weeks and patients with drug-eluting stents wait one year to undergo surgery, this study suggests that patients with either type of stent avoid operations for at least six months. This study also found that taking blood thinners didn’t make much of a difference in reducing risk of complications, which is surprising because anticoagulants reduce risk of blood clots—the most common complication associated with surgery in stent patients.

Despite conflicting findings, experts suggest that current guidelines are still accurate. Patients with bare metal stents can undergo surgery six weeks after their stent procedure with very low risk of complications. And blood thinners should still be used when possible to reduce risk of complications during surgery. However, it’s possible that patients with drug-eluting stents don’t need to wait a year to undergo surgery, as current guidelines suggest. Waiting six months after receiving a drug-eluting stent may be just enough time to undergo an operation with very low risk of complications.

Questions for You to Consider

  • How do drug-eluting stents differ from other types of stents?

  • The two main types of stents—bare-metal stents and drug-eluting stents—perform the same function of keeping the artery open and preventing it from collapsing. However, drug-eluting stents have the added function of preventing clots and tissue from forming around the stent by releasing medication.
  • What are the most common risks associated with drug-eluting stents?

  • Although drug-eluting stents are generally safe and effective, the most common complications include blood clotting around the stent and re-narrowing of the arteries, called restenosis.


Phillip Cartozian is CardioSmart

More than 20 years ago, Phillip Cartozian had two heart attacks and quintuple bypass surgery. Afterward, he changed his diet completely and ate fruit, vegetables and fish every day.

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