{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T04:26:01Z","timestamp":1778041561969,"version":"3.51.4"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Performing emergent spinal surgery within 6 months of percutaneous placement of drug-eluting coronary stent (DES) is complex. The risks of spinal bleeding in a \u201cclosed space\u201d must be compared with the risks of stent thrombosis or major cardiac event from dual antiplatelet therapy (DAPT) interruption.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>Eighty relevant English language papers published in PubMed were reviewed in detail.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>Variables considered regarding surgery in patients on DAPT for DES included: (1) surgical indications, (2) percutaneous cardiac intervention (PCI) type (balloon angioplasty vs. stenting), (3) stent type (drug-eluting vs. balloon mechanical stent), and (4) PCI to noncardiac surgery interval. The highest complication rate was observed within 6 weeks of stent placement, this corresponds to the endothelialization phase. Few studies document how to manage patients with critical spinal disease warranting operative intervention within 6 months of their PCI for DES placement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>The treatment of patients requiring urgent or emergent spinal surgery within 6 months of undergoing a PCI for DES placement is challenging. As early interruption of DAPT may have catastrophic consequences, we hereby proposed a novel protocol involving stopping clopidogrel 5 days before and aspirin 3 days before spinal surgery, and bridging the interval with a reversible P2Y12 inhibitor until surgery. Moreover, postoperatively, aspirin could be started on postoperative day 1 and clopidogrel on day 2. Nevertheless, this treatment strategy may not be appropriate for all patients, and multidisciplinary approval of perioperative antiplatelet therapy management protocols is essential.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_337_2021","type":"journal-article","created":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T19:07:58Z","timestamp":1624820878000},"page":"302","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perioperative dual antiplatelet therapy for patients undergoing spine surgery soon after drug eluting stent placement"],"prefix":"10.25259","volume":"12","author":[{"given":"Sophie M.","family":"Peeters","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of California Los Angeles, Los Angeles, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Nagasawa","sequence":"additional","affiliation":[{"name":"Department of 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