A study by researchers at Rush University Medical Center, published in the February issue of the American Journal of Neuroradiology, finds that half of patients undergoing cerebrovascular stent placement did not respond well to clopidogrel. Clopidogrel (Plavix) and aspirin are medications routinely prescribed for 1-3 months following cerebrovascular stent placement to combat the risk of blood clots (stent-thrombosis) and reclosure of the artery (re-stenosis).
“Given the importance of platelet inhibition in the prevention of in-stent thrombosis and re-stenosis, there is a great incentive to ensure that adequate antiplatelet effects are achieved in high-risk patients,” said Dr. Shyam Prabhakaran, stroke neurologist at Rush University Medical Center.
The study reviewed 76 patients who underwent cerebrovascular stent placement for various clinical indications, including wide-neck aneurysm and intracranial stenosis. Researchers used the VerifyNow rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units and the P2Y12 assay (VerifyNow) to calculate P2Y12 reaction units and percentage platelet inhibition immediately before the endovascular procedure.
In the 71 patients on aspirin in whom ARU was measured, only three patients had a low response to aspirin. Of the 55 patients in whom percentage platelet inhibition was measured, 28 patients (50.9%) had clopidogrel resistance. The researchers observed a significant association between older age (over the age of 55) and clopidogrel resistance and there was a strong effect of diabetes on platelet activity suggesting that these patients may require alternate approaches.
“Our study shows that using a point-of-care platelet function test in patients undergoing cerebrovascular stent placement is feasible and may be a valuable tool in the prevention of stent-related complications,” said Prabhakaran. “Akin to the international normalized ratio used for warfarin, platelet function tests provide objective measurement of antiplatelet efficacy and help tailor therapy on an individual basis.”
However, given these preliminary results, the researchers encourage further studies on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement.
Kim Waterman | EurekAlert!
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
17.07.2018 | Information Technology
17.07.2018 | Materials Sciences
17.07.2018 | Power and Electrical Engineering