Abstract
Aspirin therapy is usually continued throughout the perioperative period to reduce the risk for thromboembolic stroke and myocardial infarction after carotid endarterectomy (CEA). Aspirin irreversibly binds cyclooxygenase-1, thereby reducing platelet aggregation for the lifetime of each platelet. However, recent research from this unit has shown that aggregation in response to arachidonic acid increases significantly, but transiently, during CEA, which suggests that the anti-platelet effect of aspirin is temporarily reversed. The purpose of the current study was to determine when this phenomenon occurs and to identify the possible mechanisms involved. Platelet aggregation was measured in platelet-rich plasma from 41 patients undergoing CEA who were stabilized with 150 mg of aspirin daily. Blood was taken at 8 time points: before anesthesia, after anesthesia, before heparinization, 3 minutes after heparinization, 3 minutes after shunt insertion, 10 minutes after flow restoration, 4 hours postoperatively, and 24 hours postoperatively. Platelet aggregation was also measured at similar times in a group of 18 patients undergoing peripheral angioplasty without general anesthesia. All patient platelets were effectively inhibited by as...Continue Reading
References
Aug 1, 1975·Proceedings of the National Academy of Sciences of the United States of America·G J RothP W Majerus
Oct 31, 1991·Biochimica Et Biophysica Acta·T MelinA Nilsson
Feb 1, 1986·Prostaglandins, Leukotrienes, and Medicine·M R BuchananD J Nazir
Dec 1, 1994·Stroke; a Journal of Cerebral Circulation·C M HelgasonL D Brace
Mar 1, 1993·Haemostasis·T OlivecronaM Hultin
Jan 1, 1996·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M E GauntA R Naylor
Feb 14, 1998·Circulation·Z Xiao, P Théroux
Apr 18, 1998·Proceedings of the National Academy of Sciences of the United States of America·E N JohnsonC D Funk
Sep 18, 1998·European Heart Journal·C J KnightA H Goodall
Mar 27, 1999·Lancet·A A WeberK Schrör
Sep 2, 1999·Stroke; a Journal of Cerebral Circulation·G G FergusonH J Barnett
Jul 27, 2001·The American Journal of Cardiology·P A GumE J Topol
Apr 10, 2002·Circulation·John W EikelboomSalim Yusuf
May 29, 2002·Proceedings of the National Academy of Sciences of the United States of America·Bianca RoccaCarlo Patrono
Sep 21, 2002·Clinical Science·Elijah W MuriithiDavid J Wheatley
Feb 8, 2003·Stroke; a Journal of Cerebral Circulation·P M RothwellUNKNOWN European Carotid Surgery Trialist's Collaboration
Jul 23, 2003·Circulation·N ZimmermannT Hohlfeld
Citations
Mar 16, 2013·Thrombosis and Haemostasis·Greg S McMahonAlison H Goodall
Dec 6, 2012·Circulation·Tilo GrosserGarret A FitzGerald
Feb 19, 2016·British Journal of Anaesthesia·M WąsowiczW S Beattie
Jun 3, 2014·Anesthesiology Clinics·J Devin Roberts, BobbieJean Sweitzer
May 6, 2011·Thrombosis and Haemostasis·Saeed H M HalawaniIsobel Ford
Sep 28, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·J A KinsellaD J H McCabe
Aug 22, 2006·Pharmacology & Therapeutics·Marie LordkipanidzéJean G Diodati
Aug 8, 2006·European Journal of Radiology·Deepa Gopalan, Steven M Thomas
Aug 15, 2009·Journal of Vascular Surgery·George KasotakisThomas G Lynch
Oct 8, 2014·European Journal of Internal Medicine·Inna TzoranUNKNOWN RIETE investigators
Jun 5, 2007·Journal of Vascular Surgery·Afshin AssadianWolfgang Hübl
Mar 31, 2009·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·G S McMahonA R Naylor
Mar 20, 2016·Vascular·Thorsten BrennerNicolas Attigah
Sep 12, 2006·Lasers in Surgery and Medicine·Ruiping HuangGeorge S Abela
Jul 18, 2008·Anesthesia and Analgesia·Lisa T NewsomeRoger L Royster
Aug 25, 2006·Platelets·P CollinsJ Brittenden
Jun 24, 2005·Blood·P Claire WilliamsValerie B O'Donnell
Dec 5, 2019·JAMA Surgery·Robert J BeaulieuPeter K Henke
Mar 12, 2016·International Anesthesiology Clinics·Dallas Duncan, Duminda N Wijeysundera
Oct 14, 2019·Journal of Neurology·S J X MurphyD J H McCabe
Aug 5, 2008·Vascular·J Mathys VogtenJean-Paul P M de Vries
Aug 5, 2008·Vascular·Afshin AssadianWolfgang Hübl
Oct 6, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Alia Uzra KazimiWolfgang Miesbach