Perioperative and Periinterventional Platelet Function Testing

Abstract Purpose of the Review This review summarizes the current knowledge on the use of perioperative and periinterventional platelet function monitoring aiming to individualize antiplatelet therapy. Recent Findings In cardiac surgery, the recent guidelines recommend drug-specific discontinuation according to their half-lives, whereas preoperative platelet function testing is generally not supported. However, platelet function testing might be able to individualize preoperative wait time before surgery. Further, platelet function testing could be helpful in the treatment of bleeding patients and prevention from thromboembolic complications. In peripheral vascular surgery, high on-treatment platelet reactivity is associated with thrombotic complications, whereas relevant platelet inhibition in neurosurgery and vascular surgery might increase the risk of perioperative and long-term bleeding. In patients undergoing neurovascular interventions or coronary artery stenting, platelet function testing might identify patients at risk for high on-treatment platelet reactivity requiring adaptation of peri-interventional antiplatelet therapy. Further, platelet function testing might be useful to taper strong antiplatelet therapy in patients at high risk of bleeding. Summary Current evidence supporting the use of perioperative or peri-interventional platelet function testing is limited. Further, the optimal thresholds of sufficient platelet inhibition or recovered platelet function are not well defined for the various devices, and their results are usually not interchangeable.