Myocardial infarction following held antiplatelet therapy for lumbar radiofrequency neurotomy: A letter to the editor.

OBJECTIVES

Describe a catastrophic complication of holding antiplatelet therapy (APT) prior to lumbar radiofrequency neurotomy (RFN).

SETTING

Bilateral L4-5 and L5-S1 RFN was performed 72 hours after the patient was instructed to hold APT.

DISCUSSION

Several hours after the lumbar RFN, the patient experienced substernal chest pain unresponsive to oral nitroglycerin. He presented to a local emergency department and was found to have ST-elevated myocardial infarction (STEMI), for which he underwent emergent cardiac catheterization. Almost all current literature and guidelines recommend continuing APT throughout the timeframe surrounding lumbar RFN yet the practice of holding these medications continues to be utilized by physicians.

CONCLUSION

APT should not be discontinued in patients undergoing lumbar RFN due to the increased possibility of thromboembolic events such as a myocardial infarction.