Koo-Hui Chan, Mark Y. Chan and Chi-Hang Lee
Percutaneous coronary intervention with stent implantation has become the predominant revascularization strategy for patients with coronary artery disease. To reduce the risk of thrombotic complications, current guideline recommends dual antiplatelet therapy for 12 months after drug-eluting stent implantation. Dilemma arises when post-stent implantation patients have to undergo non-deferrable noncardiac surgery. In this case report, we presented a patient who have received drug-eluting stent implantation to left circumflex artery for myocardial infarction. Before staged percutaneous coronary intervention to a residual high-grade stenosis in the left anterior descending artery, he was diagnosed with renal cell carcinoma requiring nephrectomy. We describe the case of a patient requiring radical nephrectomy after multiple stent implantations and the strategies we adopted to reduce the risks of perioperative complications. The patient subsequently underwent nephrectomy successfully without perioperative myocardial infarction.