Journal
JOURNAL OF NEUROSURGERY
Volume 129, Issue 4, Pages 890-905Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2017.5.JNS162307
Keywords
aneurysm; clopidogrel; intracranial stenosis; platelet reactivity; vascular disorders
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Neuroendovascular techniques for treating cerebral aneurysms and other cerebrovascular pathology are increasingly becoming the standard of care. Intraluminal stents, aneurysm coils, and other flow diversion devices typically require concomitant antiplatelet therapy to reduce thromboembolic complications. The variability inherent with the pharmacodynamic response to common antiplatelet agents such as aspirin and clopidogrel complicates optimal selection of antiplatelet agents by clinicians. This review serves to discuss the literature related to antiplatelet use in neuroendovascular procedures and provides recommendations for clinicians on how to approach patients with variable response to antiplatelet agents, particularly clopidogrel.
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