Cases of Gastric Cancer Discovered after Drug-Eluting Coronary Stent Implantation

Fumihiko Hatao, Ikuo Wada, Hirokazu Yamaguchi, Sachiyo Nomura, Kazuhiko Yamada, Akemi Yoshikawa, Kazuhiko Mori, Hideo Fujita*, Toshihiro Morita* and Michio Kaminishi

Department of Gastrointestinal Surgery and Department of Cardiovascular Medicine*, Graduate School of Medicine, The University of Tokyo

Drug-eluting coronary stents (DES) incorporating an eluting antiproliferative agent are commonly used to treat coronary heart disease. While DES reduce the rate of coronary artery restenosis, they have a higher incidence of late thrombosis compared to bare metal stents. Patients are maintained on dual antiplatelet therapy with aspirin and thienopyridine. If the patient suffers from digestive cancer after DES implantation, antiplatelet therapy is temporarily halted, and replaced by heparin administration to avoid perioperative bleeding risk. No evidence exists, to our knowledge is that this drug substitution is safe. We report two successfully treated and one unsuccessfully treated case of gastric cancer involving DES implantation. We review the literature and propose anticoagulation treatment guidelines for DES patients undergoing surgery.

Key words
drug-eluting coronary stent, antiplatelet therapy, perioperative control

Reprint requests
Fumihiko Hatao Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
7-3-1 Hongo, Bunkyou-Ku, 113-8655 JAPAN

Accepted
July 25, 2007

To read the PDF file you will need Abobe Reader installed on your computer.