Song Jihye, Shin Yong Sam
Department of Neurosurgery, Konyang College of Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Daejeon, Republic of Korea.
Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea.
Neurol Sci. 2017 May;38(5):879-885. doi: 10.1007/s10072-017-2859-z. Epub 2017 Feb 23.
We aimed to evaluate the correlation between aspirin or clopidogrel resistance and the risk of thromboembolic events (TEs). Between June 2011 and April 2015, we reviewed clinical and angiographic characteristics, and TEs in the patients undergoing stent-assisted coil embolization (SAC) of unruptured intracranial aneurysms (UIA) at our institution. We did not modify antiplatelet medication in patients with resistance. The relationships between antiplatelet resistance and the occurrence of acute symptomatic TEs, any diffusion-positive lesions, multiple diffusion-positive lesions, or delayed TEs were investigated. Ninety-nine endovascular treatments with stent-assisted technique were performed on 99 patients. The prevalence of aspirin resistance was 12% and clopidogrel resistance was 62.6%. Acute symptomatic TEs were demonstrated in 4 patients (4%). Diffusion-positive lesions were found in 82 patients [82.1%; 36 patients were group I (≤5) and 46 patients were group II (>5)]. Delayed TEs were demonstrated in 10 patients (10.1%). Neither aspirin resistance nor clopidogrel resistance was relevant to the development of acute symptomatic TEs, any diffusion-positive lesions, multiple diffusion-positive lesions, and delayed TEs (P = not available, 0.448, 0.362, and 0.829 for aspirin resistance and P = 0.607, 0.367, 0.278, and 0.245 for clopidogrel resistance). Without modification of antiplatelet medication, we demonstrated 4% of acute symptomatic TEs and 10% of delayed TEs. Aspirin or clopidogrel resistance did not show significant relationships with acute and delayed TEs in the SAC of UIA.
我们旨在评估阿司匹林或氯吡格雷抵抗与血栓栓塞事件(TEs)风险之间的相关性。在2011年6月至2015年4月期间,我们回顾了在我院接受未破裂颅内动脉瘤(UIA)支架辅助弹簧圈栓塞术(SAC)患者的临床和血管造影特征以及TEs情况。对于存在抵抗的患者,我们未调整抗血小板药物。研究了抗血小板抵抗与急性症状性TEs、任何弥散阳性病变、多发弥散阳性病变或延迟性TEs发生之间的关系。对99例患者进行了99次支架辅助技术的血管内治疗。阿司匹林抵抗的发生率为12%,氯吡格雷抵抗的发生率为62.6%。4例患者(4%)出现急性症状性TEs。82例患者发现有弥散阳性病变[82.1%;36例患者为I组(≤5个),46例患者为II组(>5个)]。10例患者(10.1%)出现延迟性TEs。阿司匹林抵抗和氯吡格雷抵抗均与急性症状性TEs、任何弥散阳性病变、多发弥散阳性病变及延迟性TEs的发生无关(阿司匹林抵抗时P值无可用数据、0.448、0.362和0.829,氯吡格雷抵抗时P值分别为0.607、0.367、0.278和0.245)。在未调整抗血小板药物的情况下,我们观察到4%的急性症状性TEs和10%的延迟性TEs。在UIA的SAC中,阿司匹林或氯吡格雷抵抗与急性和延迟性TEs之间未显示出显著相关性。