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Specialty: Surgery
Drug: Clopidogrel
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Total 32 results found since Jan 2013.
Multi-institutional patterns of clopidogrel response among patients undergoing transcarotid artery revascularization
CONCLUSIONS: Using preoperative P2Y12 testing with a threshold PRU ≥ 194 to define CR, we identified a high prevalence of CR in patients undergoing TCAR similar to that in the pre-existing coronary literature. We found no significant differences in postoperative ischemic or hemorrhagic complications by clopidogrel response phenotype, although complication rates in the overall study cohort were low. CR may be a spectrum from responder to partial responder to complete non-responder, and this may account for the differences in our CR cohort compared to the ROADSTER 2 protocol deviation cohort. Further investigation is warra...
Source: Vascular - November 25, 2022 Category: Surgery Authors: Rae S Rokosh Caron Rockman Karan Garg Shihuan Keisin Wang Raghu L Motaganahalli Andrew C Schroeder Peter J Sobraske Michael C Stoner Yauhen A Tarbunou Rebecca A Marmor Mahmoud B Malas Thomas S Maldonado Source Type: research
Risk of bleeding complications per different perioperative antithrombotic regimes during carotid endarterectomy: a national registry analysis
CONCLUSION: The effectiveness and safety of DAPT did not differ from single antiplatelet therapy (SAPT) in patients undergoing CEA and needs further evaluation in prospective studies. Considering additional data from the literature and guideline recommendations DAPT should be started immediately after stroke until 30 days after CEA followed by SAPT, due to possible reduction in the risk of recurrency.PMID:36031046 | DOI:10.1016/j.ejvs.2022.08.020
Source: PubMed: Eur J Vasc Endovasc ... - August 28, 2022 Category: Surgery Authors: Simone Ja Donners Joost M Mekke Eline S van Hattum Raechel J Toorop Gert J de Borst Dutch Audit for Carotid Interventions (DACI) Collaborators Source Type: research
Dual Antiplatelet Therapy Is Associated with Increased Risk of Bleeding and Decreased Risk of Stroke Following Carotid Endarterectomy
Despite many patients undergoing carotid endarterectomy (CEA) being on dual antiplatelet therapy (DAPT) for cardiac or neurologic indications, the impact of such therapy on perioperative outcomes remains unclear. We aim to compare rates of postoperative bleeding, stroke and major adverse events (stroke, death or MI) among patients on Aspirin alone (ASAA) versus DAPT (Clopidogrel and Aspirin).
Source: Annals of Vascular Surgery - July 31, 2022 Category: Surgery Authors: Rohini J. Patel, Rebecca Marmor, Hanaa Dakour, Nadin Elsayed, Mokhshan Ramachandran, Mahmoud B. Malas Tags: Clinical Research Source Type: research
Ticagrelor or clopidogrel for dual antiplatelet therapy after transcarotid and transfemoral stenting of the carotid artery: are we ready for a randomized controlled trial?
In the work by Marcaccio et al,1 the efficacy and safety of perioperative dual antiplatelet therapy (DAPT) with aspirin/ticagrelor vs aspirin/clopidogrel in patients undergoing carotid artery stenting (CAS) or transcarotid artery revascularization (TCAR) was examined using data collected from the Vascular Quality Initiative. Compared with aspirin/clopidogrel, aspirin/ticagrelor was associated with a potentially lower risk of stroke/death and bleeding complications after CAS in cases in which protamine was used but a higher risk of these outcomes in the absence of protamine.
Source: Journal of Vascular Surgery - June 20, 2022 Category: Surgery Authors: Mario D'Oria, Sandro Lepidi Tags: Letter to the Editor Source Type: research
Flow Cytometry Based Platelet Reactivity Testing to Predict the Occurrence of Per-operative Solid Microemboli During Carotid Endarterectomy
CONCLUSION: Pre-operative platelet reactivity determined by flow cytometry after ADP stimulation correlated with the occurrence of intra-operative MES and post-operative MACE. Clopidogrel treatment showed the most substantial effect on reducing MES frequency and platelet reactivity measured by flow cytometry.PMID:35597705 | DOI:10.1016/j.ejvs.2022.03.005
Source: PubMed: Eur J Vasc Endovasc ... - May 21, 2022 Category: Surgery Authors: Aarent R T Brand Tesse C Leunissen Daniel van Vriesland Gerard Pasterkamp Mark Roest Suzanne J A Korporaal Rolf T Urbanus Gert J de Borst Source Type: research
An alternative reduced dose regimen of ticagrelor for neuroendovascular patients
CONCLUSIONS: A lower dose of ticagrelor (45 mg twice daily) appears to be safe and effective in this small cohort of patients who are resistant to clopidogrel per P2Y12 testing and who have increased risk of ischemic or hemorrhagic strokes due to neurovascular pathologies and implants. Further randomized studies are required to confirm these findings.PMID:35466828 | DOI:10.1177/17085381221092858
Source: Vascular - April 25, 2022 Category: Surgery Authors: Omar Kass-Hout Joseph Stern Ruth D Tangonan Rami Z Morsi Sonam Thind Tareq Kass-Hout Lee Guterman Source Type: research
Natural History of Non-operative Management in Asymptomatic Patients with 70%-80% Internal Carotid Artery Stenosis by Duplex Criteria.
CONCLUSION: Patients with asymptomatic moderate to severe carotid stenosis had a low rate of stroke/TIA without documented progression. However, there was a high rate of stenosis progression reinforcing the need to follow these patients closely.
PMID: 32660806 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - July 9, 2020 Category: Surgery Authors: Cheng TW, Pointer KE, Gopal M, Farber A, Jones DW, Eberhardt RT, Kalish JA, Eslami MH, Rybin D, Siracuse JJ Tags: Eur J Vasc Endovasc Surg Source Type: research
New Data and the Covid-19 Pandemic Mandate a Rethink of Antiplatelet Strategies in Patients With TIA or Minor Stroke Associated With Atherosclerotic Carotid Stenosis
The 2017 European Society for Vascular Surgery (ESVS) carotid guidelines, as well as a subsequent literature review, recommend clopidogrel monotherapy or combination aspirin + dipyridamole in recently symptomatic patients not undergoing carotid endarterectomy (CEA).1,2 In patients scheduled for CEA, antiplatelet therapy was recommended throughout the peri- operative period and in the long-term.1 It was advised that early treatment with aspirin + clopidogrel or aspirin + dipyridamole ‘may be considered’ in order to prevent early recurrent events in patients with transient ischaemic attack (TIA) or minor ischaemi...
Source: European Journal of Vascular and Endovascular Surgery - May 2, 2020 Category: Surgery Authors: A.R. Naylor, D.J.H. McCabe Tags: For Debate: Hot Topic Source Type: research
Anti-platelet and anti-coagulant therapy in peripheral arterial disease prior to surgical intervention.
CONCLUSION: Peripheral artery disease is a complex and multifactorial clinical condition. The use of dual anti-platelets, such as aspirin and clopidogrel, are the key in preventing major cardiovascular events as well as stroke and death. Utilization of anti-coagulation such as direct oral anti-coagulants' as additional parameters for the prevention of disease progression, is paramount. Eventually, the choice of either dual-antiplatelet therapy or combined anti-coagulation with anti-platelets should be carefully considered, particularly following the most recent published debatable studies.
PMID: 30539687 [PubMed - as ...
Source: Vascular - December 12, 2018 Category: Surgery Authors: Harky A, Maskell P, Burgess M Tags: Vascular Source Type: research
On-Treatment Platelet Reactivity is a Predictor of Adverse Events in Peripheral Artery Disease Patients Undergoing Percutaneous Angioplasty.
CONCLUSIONS: In this study a high prevalence of on-clopidogrel and aspirin high platelet reactivity was found, which was significantly associated with the risk of death. Conversely, a low on-clopidogrel platelet reactivity was associated with a higher risk of bleeding. These results document that the entity of platelet inhibition is associated with both thrombotic and bleeding complications in PAD patients.
PMID: 30025662 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - July 16, 2018 Category: Surgery Authors: Grifoni E, Gori AM, Giusti B, Valenti R, Migliorini A, Basili S, Paniccia R, Elmahdy MF, Pulli R, Pratesi C, Antoniucci D, Violi F, Marcucci R Tags: Eur J Vasc Endovasc Surg Source Type: research
A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery
Conclusions:
Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use.
Source: Annals of Surgery - December 22, 2017 Category: Surgery Tags: Features Source Type: research
Outcomes of Patients with Critical Limb Ischaemia in the EUCLID Trial.
CONCLUSIONS: Nearly 5% of patients enrolled in EUCLID had CLI at baseline. Milder forms of CLI dominated, a result of the trial design. Patients with CLI had a significantly higher rate of cardiovascular mortality and morbidity versus those without CLI. Further efforts are required to reduce the risk of cardiovascular events in PAD, especially in patients with CLI. CLINICALTRIALS.GOV: NCT01732822.
PMID: 29273390 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - December 19, 2017 Category: Surgery Authors: Norgren L, Patel MR, Hiatt WR, Wojdyla DM, Fowkes FGR, Baumgartner I, Mahaffey KW, Berger JS, Jones WS, Katona BG, Held P, Blomster JI, Rockhold FW, Björck M, EUCLID Steering Committee and Investigators Tags: Eur J Vasc Endovasc Surg Source Type: research
