A meta-analysis has found patient-specific strategies should be used during perioperative management of patients that balances risks of stopping aspirin with risks associated with continuing it. Aspirin withdrawal syndrome may significantly increase the risk of major thromboembolic complications in patients taking aspiring for secondary cardiovascular prevention. The authors noted that the risk of perioperative bleeding while continuing aspirin was minimal. They suggest that aspirin should be stopped in patients undergoing intracranial surgery, middle ear surgery, and posterior eye surgery as well as in intramedullary spine surgery and possibly transurethral prostatectomy.

Abstract: Annals of Surgery, May 2012.