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

Matsumoto Y, Kondo R, Matsumori Y, Shimizu H, Takahashi A, Tominaga T - Drugs R D (2012)

Bottom Line: 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).Clopidogrel was generally well tolerated with no signs of hemorrhagic complications or liver dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan.

ABSTRACT

Background: 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.

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Related in: MedlinePlus

Frequency of high-intensity areas by aneurysm size (< or ≥10 mm) at 24 hours post-coil embolization for unruptured cerebral aneurysm following aspirin (acetylsalicylic acid) or clopidogrel treatment.
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Fig2: Frequency of high-intensity areas by aneurysm size (< or ≥10 mm) at 24 hours post-coil embolization for unruptured cerebral aneurysm following aspirin (acetylsalicylic acid) or clopidogrel treatment.

Mentions: The incidence of HIA assessed by MRI-DWI at 24 hours after coiling was significantly lower with clopidogrel than aspirin (20.6% vs 39.1%; p = 0.02) [figure 1]; ischemic lesions were detected in 13/63 clopidogrel-treated compared with 27/69 aspirin-treated patients. Notably, the rate of HIA occurrence was statistically significantly lower in clopidogrel- than aspirin-treated patients for small (<10 mm) lesions (8/54 [14.8%] vs 22/60 [36.7%]; p = 0.008), while for larger (≥10 mm) lesions, the rate was also markedly reduced (3/9 [33.3%] vs 5/9 [55.6%]); however, statistical significance was not shown although this may have been due to the small size of these cohorts (figure 2).


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

Matsumoto Y, Kondo R, Matsumori Y, Shimizu H, Takahashi A, Tominaga T - Drugs R D (2012)

Frequency of high-intensity areas by aneurysm size (< or ≥10 mm) at 24 hours post-coil embolization for unruptured cerebral aneurysm following aspirin (acetylsalicylic acid) or clopidogrel treatment.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585694&req=5

Fig2: Frequency of high-intensity areas by aneurysm size (< or ≥10 mm) at 24 hours post-coil embolization for unruptured cerebral aneurysm following aspirin (acetylsalicylic acid) or clopidogrel treatment.
Mentions: The incidence of HIA assessed by MRI-DWI at 24 hours after coiling was significantly lower with clopidogrel than aspirin (20.6% vs 39.1%; p = 0.02) [figure 1]; ischemic lesions were detected in 13/63 clopidogrel-treated compared with 27/69 aspirin-treated patients. Notably, the rate of HIA occurrence was statistically significantly lower in clopidogrel- than aspirin-treated patients for small (<10 mm) lesions (8/54 [14.8%] vs 22/60 [36.7%]; p = 0.008), while for larger (≥10 mm) lesions, the rate was also markedly reduced (3/9 [33.3%] vs 5/9 [55.6%]); however, statistical significance was not shown although this may have been due to the small size of these cohorts (figure 2).

Bottom Line: 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).Clopidogrel was generally well tolerated with no signs of hemorrhagic complications or liver dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan.

ABSTRACT

Background: 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.

Show MeSH
Related in: MedlinePlus