Taylor L Ian, Dickerson James C, Dambrino Robert J, Kalani M Yashar S, Taussky Philipp, Washington Chad W, Park Min S
University of Mississippi Medical Center, Jackson, Mississippi.
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah; and.
Neurosurg Focus. 2017 Jun;42(6):E5. doi: 10.3171/2017.3.FOCUS1746.
OBJECTIVE Although the use of dual antiplatelet therapy with flow diversion is recommended and commonplace, the testing of platelet inhibition is more controversial. METHODS The authors reviewed the medical literature to establish and describe the physiology of platelet adhesion, the pharmacology of antiplatelet medications, and the mechanisms of the available platelet function tests. Additionally, they present a review of the pertinent neurointerventional and interventional cardiology literature. RESULTS Competing reports in the neurointerventional literature argue for and against the use of routine platelet function testing, with adjustments to the dosage or medications based on the results. The interventional cardiology literature has also wrestled with this dilemma after percutaneous coronary interventions, with conflicting reports of the benefits of platelet function testing. CONCLUSIONS Despite its prevalence, the benefits of platelet function testing prior to flow diversion are unproven. This practice will likely remain controversial until the level of evidence improves through more rigorous testing and reporting.
目的 尽管推荐并普遍采用双重抗血小板治疗联合血流导向装置，但血小板抑制检测仍存在更多争议。方法 作者回顾医学文献，以确立并描述血小板黏附的生理学、抗血小板药物的药理学以及现有血小板功能检测的机制。此外，他们还对相关的神经介入和介入心脏病学文献进行了综述。结果 神经介入文献中相互矛盾的报告对常规血小板功能检测的使用持支持和反对意见，并根据检测结果调整剂量或药物。介入心脏病学文献在经皮冠状动脉介入治疗后也面临这一困境，关于血小板功能检测的益处报告相互矛盾。结论 尽管血流导向装置术前进行血小板功能检测很普遍，但其益处尚未得到证实。在通过更严格的检测和报告提高证据水平之前，这种做法可能仍会存在争议。
