RT Journal Article
SR Electronic
T1 Perioperative management of adult patients with a history of stroke or transient ischaemic attack undergoing elective non-cardiac surgery
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 535
OP 540
DO 10.7861/clinmedicine.16-6-535
VO 16
IS 6
A1 Zehra Mehdi
A1 Jonathan Birns
A1 Judith Partridge
A1 Ajay Bhalla
A1 Jugdeep Dhesi
YR 2016
UL http://www.rcpjournals.org/content/16/6/535.abstract
AB It is increasingly common for physicians and anaesthetists to be asked for advice in the medical management of surgical patients who have an incidental history of stroke or transient ischaemic attack (TIA). Advising clinicians requires an understanding of the common predictors, outcomes and management of perioperative stroke. The most important predictor of perioperative stroke is a previous history of stroke, and outcomes associated with such an event are extremely poor. The perioperative management of this patient group needs careful consideration to minimise the thrombotic risk and a comprehensive, individualised approach is crucial. Although there is literature supporting the management of such patients undergoing cardiac surgery, evidence is lacking in the setting of non-cardiac surgical intervention. This article reviews the current evidence and provides a pragmatic interpretation to inform the perioperative management of patients with a history of stroke and/or TIA presenting for elective non-cardiac surgery.