Variability in initial response to standard clopidogrel therapy, delayed conversion to clopidogrel hyper-response, and associated thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms

Journal of Neurointerventional Surgery
Josser E Delgado AlmandozDavid E Tubman

Abstract

Variability in response to clopidogrel therapy is increasingly being recognized as an important factor in thromboembolic and hemorrhagic complications encountered after neurointerventional procedures. This study aims to determine the variability in response to clopidogrel therapy and associated complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms. We recorded baseline patient characteristics, co-administered medications, P2Y12 reaction units (PRU) values with VerifyNow, clopidogrel dosing, and thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms at our institution during a 19 month period. 100 patients were included in the study, 76 women and 24 men, mean age 57.3 years. 15 patients exhibited an initial clopidogrel hypo-response (PRU >240) and 21 patients an initial clopidogrel hyper-response (PRU <60). 36 patients had a follow-up VerifyNow test performed without changes to the standard 75 mg daily clopidogrel dose, which demonstrated that 59% of patients who had initially been within the target 60-240 PRU range exhibited a delayed conversion to clopidogrel hyper-response. In our cohort, a clopidogrel hypo-response was...Continue Reading

References

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Citations

Jun 28, 2014·Journal of Neurointerventional Surgery·Min S ParkCameron G McDougall
Aug 25, 2015·Journal of Neurointerventional Surgery·Hidehisa NishiJun-Ichi Kira
Oct 22, 2016·AJNR. American Journal of Neuroradiology·M Barburoglu, A Arat
Apr 11, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Pegah GhamasaeeRamesh Grandhi
Jun 2, 2017·Neurosurgical Focus·L Ian TaylorMin S Park
Oct 14, 2017·Journal of Neurology, Neurosurgery, and Psychiatry·Marcus D MazurWilliam T Couldwell
Feb 23, 2018·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Yon Kwon IhnIn Sup Choi
Sep 8, 2016·Journal of Neurointerventional Surgery·Matthew T BenderAlexander L Coon
Oct 28, 2019·Journal of Neurointerventional Surgery·Alejandro GonzálezAurelio Cayuela
Nov 17, 2016·Journal of Cerebrovascular and Endovascular Neurosurgery·Jung Wook BaekJung Hwa Seo
Jun 6, 2019·Clinical Neuroradiology·Ismail OranFatih Duzgun
Nov 12, 2020·Neuroradiology·Gustavo M CortezRicardo A Hanel
Jun 4, 2021·Journal of Neurointerventional Surgery·Timothy R MillerDheeraj Gandhi
Aug 28, 2021·Journal of Personalized Medicine·Karol WiśniewskiDariusz J Jaskólski

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