Recommendation 6. In patients undergoing PCI who are treated with a BMS and who require elective noncardiac surgery, we recommend delaying surgery for at least 1 month after PCI (Strong Recommendation; Moderate-Quality Evidence).
Recommendation 7. In patients undergoing PCI who are treated with a DES and who require elective noncardiac surgery, we recommend delaying surgery for at least 3 months after PCI (Strong Recommendation; Moderate-Quality Evidence). If there is a need for semiurgent noncardiac surgery, we suggest delaying surgery for at least 1 month after PCI (Weak Recommendation; Low-Quality Evidence).
Recommendation 8. In patients undergoing PCI who are treated with either a BMS or DES and who require elective noncardiac surgery, we suggest continuing ASA perioperatively whenever possible (Weak Recommendation; Low-Quality Evidence).
Recommendation 9. In patients undergoing PCI who are treated with a BMS or DES and who require elective noncardiac surgery, we suggest withholding clopidogrel and ticagrelor for 5-7 days preoperatively, and prasugrel for 7-10 days preoperatively (Weak Recommendation; Low-Quality Evidence).
Recommendation 10. In patients undergoing PCI who are treated with a BMS or DES and who have undergone noncardiac surgery, we suggest restarting maintenance-dose DAPT after surgery, as soon as it is deemed safe by the surgeon (Weak Recommendation; Very Low-Quality Evidence).
Practical tip. The risk and consequences of perioperative bleeding will vary considerably depending on the type of surgery performed. Some minor surgical procedures carry a low risk of bleeding, whereas others a very high risk of bleeding. For example, some dental, ophthalmological, and endoscopic procedures carry a low risk of bleeding and can be performed without stopping antiplatelet therapy.