Yi Ho Jun, Hwang Gyojun, Lee Byoung Hun
Department of Neurosurgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2019 Jan;62(1):3-9. doi: 10.3340/jkns.2018.0151. Epub 2018 Dec 31.
As more intracranial aneurysms and other cerebrovascular pathologies are treated with neurointervention procedure, thromboembolic events that frequently lead to serious neurological deficit or fatal outcomes are increasing. In order to prevent the thromboembolic events, antiplatelet therapy is used in most procedures including coil embolization, stenting, and flow diversion. However, because of variable individual pharmacodynamics responses to antiplatelet drugs, especially clopidogrel, it is difficult for clinicians to select the adequate antiplatelet regimen and its optimal dose. This article reviews the neurointervention literature related to antiplatelet therapy and suggests a strategy for tailoring antiplatelet therapy in individual patients undergoing neurointervention based on the results of platelet function testing.
随着越来越多的颅内动脉瘤和其他脑血管病变采用神经介入手术治疗，频繁导致严重神经功能缺损或致命后果的血栓栓塞事件也在增加。为预防血栓栓塞事件，在大多数手术中，包括弹簧圈栓塞、支架置入和血流导向术，都会使用抗血小板治疗。然而，由于个体对抗血小板药物，尤其是氯吡格雷的药效学反应存在差异，临床医生很难选择合适的抗血小板治疗方案及其最佳剂量。本文回顾了与抗血小板治疗相关的神经介入文献，并根据血小板功能检测结果，提出了一种针对接受神经介入手术的个体患者量身定制抗血小板治疗的策略。
