Medical Emergencies · patient case question
Patient A takes aspirin and clopidogrel. What modification is required before a routine simple extraction?
Patient case: Bleeding Risk Assessment
demo: 3 patients presenting for extractions on the same morning
chief: Pre-operative hemostasis assessment
history: Patient A: coronary stent, taking aspirin and clopidogrel. Patient B: hemophilia A. Patient C: family history of easy bruising and prolonged bleeding after minor cuts.
meds: See individual histories
findings: All three require routine simple extractions.
Show answer and explanation
Correct answer: C. No modification — proceed with local hemostatic measures
- A. Selective interruption still carries thrombotic risk and is a physician decision, not a routine dental one.
- B. A 10-day interruption exposes the patient to stent thrombosis, a far graver outcome than local oozing.
- C. Correct. Dual antiplatelet therapy should not be interrupted for routine dental surgery. The thrombotic risk of stopping outweighs the bleeding risk, which is controlled with pressure, sutures, and local agents.
- D. Platelet transfusion is reserved for genuine thrombocytopenia, not for pharmacologic inhibition before minor surgery.
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