Principal Investigator: Paul Shekelle, MD PhD Co-Investigators: Melinda Maggard-Gibbons, MD, MSHS; Isomi M. Miake-Lye, PhD; Christopher P. Childers, MD; Sean M. O'Neill, MD, PhD Contributing Investigators: Selene Mak, PhDc; Roberta Shanman, MLS; Jessica M. Beroes, BS
Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, DLos Angeles, CA;
Washington (DC): Department of Veterans Affairs; October 2017.
The perioperative management of antiplatelet therapy (APT) for patients with cerebrovascular or peripheral vascular diseases remains unclear.
This review was requested to assess the evidence for the following Key Questions:
1. Among patients on APT for cerebrovascular disease or peripheral vascular disease undergoing elective non-cardiac surgical procedures, including intraocular procedures, what are the benefits and harms of holding APT prior to surgery?
2. How does benefit/risk vary by the timing of discontinuation?
3. How does benefit/risk vary by type of surgical procedure, including intraocular procedures?
4. How does benefit/risk vary by type of APT?
5. How does benefit/risk vary by the timing of resuming APT?