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

For which condition is the use of prophylactic aspirin indefinitely recommended?

1. Type 1 gastric carcinoid

2. Bare metal stent placement

3. Laparoscopic gastric banding

4. Laparoscopic sleeve gastrectomy

The correct answer is: Bare metal stent placement

Prophylactic aspirin is often recommended indefinitely following bare metal stent placement due to its role in preventing stent thrombosis. After the placement of a bare metal stent, patients are at increased risk for thrombotic events, particularly in the early period following the procedure. Aspirin acts as an antiplatelet agent, reducing the likelihood of clot formation on the stent surface and preserving vessel patency. Long-term aspirin therapy is considered especially important in patients who may have risk factors for cardiovascular events, as stent thrombosis can be a serious complication leading to acute coronary syndrome or myocardial infarction. It is essential to manage these risks carefully in patients who have undergone procedures involving intra-arterial interventions. In contrast, the other options listed do not have the same level of established recommendation for indefinite prophylactic aspirin use. For example, conditions such as type 1 gastric carcinoid, laparoscopic gastric banding, and laparoscopic sleeve gastrectomy do not typically require long-term antiplatelet therapy for prevention of complications in the same manner as stent placements do. Thus, the focus on cardiovascular protection specifically after stent placement makes it the correct choice in this context.