Tsujimoto Masanori, Enomoto Yukiko, Miyai Masafumi, Egashira Yusuke, Iwama Toru
1 Department of Neurosurgery, 73882 Daiyukai General Hospital, Sakura, Ichinomiya city, Aichi, Japan.
2 Department of Neurosurgery, Gifu University Graduate School of Medicine, Yanagido, Gifu city, Gifu, Japan.
J Int Med Res. 2018 May;46(5):1866-1875. doi: 10.1177/0300060518762949. Epub 2018 Mar 19.
Purpose To determine the best platelet function test for in-stent tissue protrusion following carotid artery stenting (CAS). Methods Patients who underwent CAS were recruited prospectively in this observational study. Combination of aspirin 100 mg/day and clopidogrel 75 mg/day was administered for a minimum of 7 days prior to procedure. Platelet aggregation was measured by light transmittance aggregometry (LTA) following stimulation by adenosine diphosphate (ADP), collagen, and thrombin receptor activating peptide (TRAP) and by the point of care assay, VerifyNow which measures aspirin and thienopyridine reaction units. Results In-stent tissue protrusion with maximum projection area of ≥1 mm was detected by optical coherence tomography (OCT) in 10/28 (36%) patients. Baseline characteristics were not significantly different between the two in-stent size groups (i.e., ≥1 mm vs. <1 mm) but after stimulation by collagen at 10 and 20 μg/ml, platelet reactivity as measured by LTA was significantly higher in the ≥1 mm group compared with the <1 mm group. No other differences in platelet function were detected. Conclusions Collagen-induced platelet reactivity was related to in-stent tissue protrusion size following CAS.
目的 确定用于评估颈动脉支架置入术（CAS）后支架内组织突出的最佳血小板功能检测方法。方法 在这项观察性研究中前瞻性招募接受CAS的患者。在手术前至少7天给予100 mg/天阿司匹林和75 mg/天氯吡格雷联合治疗。通过光透射聚集法（LTA）在二磷酸腺苷（ADP）、胶原和凝血酶受体激活肽（TRAP）刺激后测量血小板聚集，并通过即时检测法VerifyNow测量阿司匹林和噻吩并吡啶反应单位。结果 通过光学相干断层扫描（OCT）在10/28（36%）例患者中检测到最大突出面积≥1 mm的支架内组织突出。两个支架内尺寸组（即≥1 mm与<1 mm）的基线特征无显著差异，但在10和20 μg/ml胶原刺激后，通过LTA测量的≥1 mm组血小板反应性显著高于<1 mm组。未检测到血小板功能的其他差异。结论 胶原诱导的血小板反应性与CAS后支架内组织突出大小有关。
