American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the recommended duration for aspirin and Plavix after placement of a bare metal stent?

1. 1 month ASA + Plavix

2. 3 months ASA + Plavix

3. 6 months ASA + Plavix

4. Aspirin forever

The correct answer is: 3 months ASA + Plavix

In the context of managing patients who have undergone percutaneous coronary intervention (PCI) with a bare metal stent (BMS), the recommended duration of dual antiplatelet therapy (DAPT) typically includes aspirin and clopidogrel (Plavix) for a period of three months. This recommendation is based on evidence showing that this duration strikes a balance between reducing the risk of stent thrombosis, which is a significant concern immediately following stent placement, and minimizing the risk of bleeding associated with long-term antiplatelet therapy. During the first month after stent placement, the risk of thrombosis is highest, and maintaining an adequate duration of DAPT is crucial to prevent this potentially life-threatening complication. After three months, the risk of stent thrombosis decreases significantly, and the need for ongoing dual therapy can be reassessed based on individual patient risk factors. Longer durations of DAPT, such as six months or indefinitely, are more commonly recommended for patients with drug-eluting stents due to their different risk profiles associated with thrombosis. However, for bare metal stents, three months of DAPT has been a standard practice, as it is adequate for reducing the risk without unnecessarily increasing the bleeding risk associated with prolonged