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Antiplatelet therapy for prevention of thromboembolic complications associated with coil embolization of unruptured cerebral aneurysms.

AbstractBACKGROUND:
Antiplatelet agents are used during endovascular treatment of cerebral aneurysms to prevent thromboembolic complications.
OBJECTIVE:
The aim of this study was to investigate the efficacy of clopidogrel for the prevention of thromboembolic complications during elective coil embolization of unruptured cerebral aneurysms.
METHODS:
Sixty-three patients prospectively received oral clopidogrel 75 mg/day from 3 days before and for 1 day after the procedure at our institute (Kohnan Hospital, Sendai, Japan) during 2007.
RESULTS:
At 24 hours post-coiling, significantly less high-intensity areas, detected by MRI with diffusion-weighted imaging (MRI-DWI), were observed in clopidogrel-treated patients compared with a historical control cohort of aspirin (acetylsalicylic acid)-treated patients (13/63 [20.6%] vs 27/69 [39.1%]; p = 0.02), primarily due to a statistically significantly lower rate during repair of small (<10 mm) lesions (p = 0.008). Also, the rate of periprocedural thromboembolic events was lower in the clopidogrel than the aspirin cohort (2/63 [3.2%] vs 5/69 [7.2%]; p = 0.3).
CONCLUSIONS:
Clopidogrel was generally well tolerated with no signs of hemorrhagic complications or liver dysfunction.
AuthorsYasushi Matsumoto, Ryushi Kondo, Yasuhiko Matsumori, Hiroaki Shimizu, Akira Takahashi, Teiji Tominaga
JournalDrugs in R&D (Drugs R D) Vol. 12 Issue 1 Pg. 1-7 (Mar 01 2012) ISSN: 1179-6901 [Electronic] New Zealand
PMID22242721 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Aspirin (administration & dosage, therapeutic use)
  • Cerebral Angiography
  • Clopidogrel
  • Embolization, Therapeutic (adverse effects)
  • Female
  • Humans
  • Incidence
  • Intracranial Aneurysm (complications, diagnostic imaging, therapy)
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors (administration & dosage, therapeutic use)
  • Prospective Studies
  • Retrospective Studies
  • Thromboembolism (epidemiology, etiology, prevention & control)
  • Ticlopidine (administration & dosage, analogs & derivatives, therapeutic use)
  • Treatment Outcome
  • Young Adult

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