Clopidogrel load for emboli reduction in patients with symptomatic carotid stenosis undergoing urgent carotid endarterectomy

Stroke; a Journal of Cerebral Circulation
Georgios TsivgoulisAndrei V Alexandrov

Abstract

Microembolic signals (MES) on transcranial Doppler are an independent risk factor for recurrent stroke in patients with extracranial symptomatic/asymptomatic carotid artery stenosis (CARAS). Clopidogrel load (300 mg) combined with dual antiplatelet therapy has been shown to reduce MES in patients with symptomatic CARAS. We sought to determine feasibility of clopidogrel load in decreasing asymptomatic embolization in patients with symptomatic CARAS undergoing urgent carotid endarterectomy within the first 2 weeks from the index event. Subjects and Consecutive patients with symptomatic CARAS (70%-99%) and presence of MES on 1-hour baseline (<24 hours from the index event) transcranial Doppler monitoring of ipsilateral middle cerebral artery were treated with clopidogrel load followed by clopidogrel (75 mg)±aspirin (100 mg) during the elapsed time period between hospital admission and urgent carotid endarterectomy at 3 tertiary-care stroke centers. Repeat 1-hour transcranial Doppler monitoring was performed the day before surgery. Bleeding complications during surgery and recurrent strokes or transient ischemic attacks during the first month of ictus were prospectively recorded. A total of 11 symptomatic CARAS patients (mean age, ...Continue Reading

References

Mar 20, 1998·Stroke; a Journal of Cerebral Circulation·E B RingelsteinM Siebler
Apr 9, 2005·Stroke; a Journal of Cerebral Circulation·Hugh S Markus, Andrew MacKinnon
Sep 12, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·Y IguchiT Inoue
Oct 24, 2009·Stroke; a Journal of Cerebral Circulation·Alice King, Hugh S Markus

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Citations

Jan 29, 2014·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Georgios TsivgoulisAndrei V Alexandrov
Apr 11, 2013·Expert Review of Cardiovascular Therapy·Joseph L Blackshear, Thomas G Brott
Oct 3, 2013·Annals of Vascular Surgery·Sara Mercedes Morales GisbertEduardo Ortiz Monzón
Mar 8, 2016·Journal of Vascular Surgery·Douglas W JonesDavid H Stone
Jan 16, 2013·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Antonios KerasnoudisChristos Krogias
May 20, 2014·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G TsivgoulisS N Vasdekis
Aug 6, 2016·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Alejandro M BrunserVioleta Díaz
Oct 16, 2016·Continuum : Lifelong Learning in Neurology·Georgios Tsivgoulis, Andrei V Alexandrov
May 3, 2014·Therapeutic Advances in Neurological Disorders·Georgios TsivgoulisAndrei V Alexandrov
Feb 1, 2019·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Odysseas KargiotisGeorgios Tsivgoulis
Apr 2, 2019·Stroke; a Journal of Cerebral Circulation·Dohoung KimHee-Joon Bae
Aug 29, 2020·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Alejandro M BrunserVioleta Díaz
Jun 12, 2018·Journal of Stroke·Georgios TsivgoulisAndrei V Alexandrov
May 26, 2017·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Brett R Graham, Bijoy K Menon
Nov 17, 2020·Current Opinion in Neurology·Odysseas Kargiotis, Georgios Tsivgoulis

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