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Antiplatelets and Anticoagulants in Ischemic Stroke,Transient Ischaemic Attack: A Practice Survey Among Singapore Neurologists
CONCLUSIONS: The widespread use of aspirin for long-term secondary prevention is similar to other countries. The variation in the use of antithrombotic agents in other settings may reflect the lack of sufficient evidence to guide therapy in the various specific stroke patient management scenarios.KEY WORDS: neurologist, practice, antiplatelet, anticoagulant, stroke, cerebrovascular disease.PMID:35470408
Source: Acta Neurologica Taiwanica - April 26, 2022 Category: Neurology Authors: Narayanaswamy Venketasubramanian Source Type: research

Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome
Antiplatelets agents are widely used and effective for secondary prevention of vascular diseases. Some patients might have reduced platelet inhibition on antiplatelet therapy with a higher risk of ischemic complications.1,2 The role of platelet function monitoring (PFM) has been extensively investigated in cardiology. Resistance to Clopidogrel correlates with higher risk of long-term cardiovascular events and coronary stent thrombosis.3,4 Similarly, studies performed after elective carotid stenting showed that ischemic recurrence and early stent thrombosis are more common in non-responders to Clopidogrel.
Source: Journal of Stroke and Cerebrovascular Diseases - May 5, 2021 Category: Neurology Authors: Ludovico Ciolli, Nicoletta Lelli, Francesca Rosafio, Stefania Maffei, Federico Sacchetti, Laura Vandelli, Maria Luisa Dell'Acqua, Livio Picchetto, Giuseppe Maria Borz ì, Riccardo Ricceri, Roberta Pentore, Manuela Tondelli, Gabriele Vandelli, Noelia Rodrà Source Type: research

Clopidogrel underactivity is a common in patients with acute symptomatic severe carotid stenosis
Clopidogrel is commonly used for secondary stroke prevention in patients with large vessel stenosis. Reduced Clopidogrel high on treatment platelet reactivity (CR) can lead to Clopidogrel underactivity (CU) causing acute thrombosis. However, the prevalence of CU among patients with acute symptomatic carotid disease remains unknown. Therefore, we aimed to find the prevalence and identify the predictors for CU among patients with acutely symptomatic carotid stenosis.
Source: Journal of the Neurological Sciences - April 14, 2021 Category: Neurology Authors: A. Honig, T. Sacagiu, A. Filioglo, N. Simaan, J. Kalish, J.M. Gomori, A. Horev, R.R. Leker, J.E. Cohen Tags: Clinical short communication Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Safety of OnabotulinumtoxinA Treatment With Concomitant Antithrombotic Therapy in Patients With Post-stroke Spasticity: A Pooled Analysis of Randomized, Double-Blind Studies (S56.008)
Conclusions:There is no apparent increased risk of bleeding complications in patients on antithrombotics following IM onabotA treatment; nonetheless, careful observation of the injection site and patient education of the potential for bleeding complications remain warranted.Study Supported by: Allergan plc, Dublin, IrelandDisclosure: Dr. Dimitrova has received personal compensation for activities with Allergan as an employee. Dr. Dimitrova holds stock and/or stock options in Allergan. Dr. James has received personal compensation for activities with Allergan and Chase Pharmaceuticals as an employee. Dr. Liu has received per...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Dimitrova, R., James, L., Liu, C., Orejudos, A., Yushmanova, I., Brin, M. Tags: Movement Disorders: Huntington ' s Disease and Drug-Induced Dyskinesias Source Type: research

Hyperacute Carotid Stenting for Acute Ischemic Stroke After Systemic Thrombolysis with IV rt-PA (P1.282)
Conclusions:These 2 cases demonstrate a successful use of hyperacute carotid stenting and antiplatelet load in patients who received systemic thrombolysis with IV rt-PA. Both had excellent outcomes and no complications. This management may be considered in patients with similar clinical and imaging characteristics.Disclosure: Dr. Marulanda-Londoño has nothing to disclose. Dr. DeLeon-Bendetti has nothing to disclose. Dr. Ortiz has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Marulanda-Londono, E., DeLeon-Bendetti, A., Ortiz, G. Tags: Cerebrovascular Disease Case Reports I Source Type: research

Comment The cause of stroke matters for secondary prevention
Cardiologists do not have to obsess about the cause of acute coronary syndromes. In more than 75% of cases, the cause of the myocardial infarction is plaque rupture with local thrombus formation.1 An understanding of this mechanism drives secondary prevention —ie, antiplatelet therapy. After acute coronary syndromes, patients are initially treated with aspirin to prevent further vascular events. Findings from studies have shown the superiority of the combination of aspirin with clopidogrel to aspirin alone2 and of more potent antiplatelet drugs, such a s ticagrelor3 or prasugrel.
Source: Lancet Neurology - March 15, 2017 Category: Neurology Authors: Hans-Christoph Diener Tags: Comment Source Type: research

Risk Factors of Subacute Thrombosis After Intracranial Stenting for Symptomatic Intracranial Arterial Stenosis Brief Report
Conclusions—Tandem stenting and antiplatelet resistance might contribute to the development of SAT after intracranial stenting in patients with symptomatic intracranial arterial stenosis.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Xuan Sun, Xu Tong, Wai Ting Lo, Dapeng Mo, Feng Gao, Ning Ma, Bo Wang, Zhongrong Miao Tags: Stent, Ischemic Stroke, Stenosis, Thrombosis Brief Reports Source Type: research

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