What is the risk of surgery after having a stent placement?

This paper studied the safety of noncardiac surgery following a recent stent placement.

After an insertion of a stent (mesh tube that treats narrowed arteries), some patients undergo surgery that is not for the heart. Such noncardiac surgery has shown to increase the risk of adverse events (undesired effect of treatment) associated with the heart. It is not clear how time, the type of surgery, and stent type affect the risk of adverse events. 

Patients who had undergone a stent placement were studied. Patients who had surgery after stent placement were compared to patients who did not have surgery.  

In the 30 days following surgery, there were higher rates of heart attacks and mortality among patients who had surgery (20,590) than those who did not (41,180). Over 24 months, there was a similar occurrence of adverse cardiac events among patients who had surgery and those who did not.

The risks of adverse events based on the type of stent used was studied. Following a bare-metal stent (wire tube) placement, 18.6% of patients who had surgery and 19% of patients who did not have surgery had an adverse cardiac event. Following a drug eluting stent (stent that releases drugs) placement, 16.2% of patients who had surgery and 15.1% of patients who did not have surgery had an adverse cardiac event.

When surgeries were performed in the first 6 weeks following stent placement, the overall rates of  heart attack and death were higher than when surgery is performed later than 6 weeks. Elective inpatient procedures (procedures that are patient's choice and not an emergency), high-risk surgery and drug-eluting stents were associated with a reduced risk following surgery more than 6 months after stent placement.

The authors concluded that risks of surgery are highest in the first 6 months after stent placement. The authors suggested that patients undergoing elective procedures or high-risk surgery and patients with drug eluting stents may benefit from delaying treatment to 6 months after stent placement.

Talk to your doctor about whether noncardiac surgery and other procedures should be delayed to 6 months after stent placement.