Dual antiplatelet therapy (DAPT) remains a cornerstone of medical therapy to minimize major adverse cardiovascular events (MACE), including stent thrombosis, after percutaneous coronary intervention (PCI). As interruption or early discontinuation of DAPT after PCI significantly increases the risk of MACE, the decision to discontinue DAPT in the perioperative setting for either cardiac or non-cardiac surgery remains a clinical dilemma. In an effort to mitigate the increased risk of early discontinuation of DAPT before surgery, clinicians have adopted a “bridging” strategy in which 1) thienopyridines such as clopidogrel and prasugrel, along with the oral P2Y12 inhibitor ticagrelor, are held before surgery; 2) short-acting intravenous platelet inhibitors are initiated with either glycoprotein IIb/IIIa inhibitors such as eptifibatide and tirofiban or the P2Y12 inhibitor cangrelor; and 3) the intravenous platelet inhibitor is discontinued shortly before surgery, with reinitiation of oral antiplatelet therapy shortly after surgery. This strategy was assessed in the BRIDGE trial, in which patients with acute coronary syndrome treated with PCI and stent placement discontinued oral thienopyridines before cardiac surgery and were randomized to either placebo or cangrelor. Cangrelor did not increase the risk of periprocedural bleeding while it maintained adequate platelet inhibition prior to surgery. However, this strategy is costly not only given the increased cost associated with the prolonged infusion of intravenous platelet inhibitors but also because of the prolonged hospitalization before surgery, as the infusion is administered in the inpatient setting. Furthermore, there is a paucity of data regarding whether this bridging strategy decreases perioperative MACE in prospective randomized controlled trials. In fact, while oral antiplatelet therapy was shown to increase the risk of surgical bleeding, there was no evidence that continuation of oral antiplatelet therapy in the perioperative setting had any impact on reducing myocardial infarction, stroke, or mortality. Additionally, the incidence of thrombotic MACE in the setting of antiplatelet therapy interruption for surgery within 2 years of PCI is quite low, at 1%.