Uneventful removal of an epidural catheter guided by impedance aggregometry in a patient with recent coronary stenting and treated with clopidogrel and acetylsalicylic acid

Reg Anesth Pain Med. 2007 Jul-Aug;32(4):354-7. doi: 10.1016/j.rapm.2007.06.007.

Abstract

Objective: This report suggests that impedance aggregometry can be helpful to assess optimum time for and minimize the risk of catheter removal during double antiplatelet therapy.

Case report: A 52-year-old patient undergoing cystectomy during combined general and epidural anesthesia suffered an acute myocardial infarction, and required coronary artery stenting and dual antiplatelet function therapy.

Conclusions: Balancing the risks of stent occlusion and epidural bleeding, bedside impedance aggregometry helped to identify the optimum time window for epidural catheter removal with the lowest bleeding risk in this patient.

Publication types

  • Case Reports

MeSH terms

  • Analgesia, Epidural / instrumentation*
  • Aspirin / therapeutic use
  • Catheterization
  • Clopidogrel
  • Cystectomy*
  • Device Removal*
  • Electric Impedance
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Myocardial Infarction / therapy*
  • Platelet Aggregation
  • Platelet Aggregation Inhibitors / therapeutic use
  • Platelet Function Tests / methods*
  • Postoperative Complications
  • Stents
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin