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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Kim, Min Soo (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) Park, Eun Suk (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) Park, Jun Bum (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) Lyo, In Uk (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) Sim, Hong Bo (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) Kwon, Soon Chan (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제2호
발행연도
2018.1
수록면
201 - 211 (11page)

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Objective : The purpose of this study was to analyze the variability of clopidogrel responses according to duration of a clopidogrel drug regimen after stent-assisted coil embolization (SAC), and to determine the correlation between the variability of clopidogrel responses and thromboembolic or hemorrhagic complications. Methods : A total of 47 patients who underwent SAC procedures to treat unruptured intracranial aneurysms were enrolled in the study. Preoperatively, patients received more than seven days of aspirin (100 mg) and clopidogrel (75 mg), daily. P2Y12 reaction unit (PRU) was checked with the VerifyNow test one day before the procedure (pre-PRU) and one month after the procedure (post-PRU). PRU variability was calculated as the difference between the initial response and the follow-up response. Patients were sorted into two groups based on their response to treatment : responsive and hypo-responsive. Results : PRU variability was significantly greater in the hypo-responsive group when compared to the responsive group (p=0.019). Pre-PRU and serum platelets counts were significantly correlated with PRU variation (p=0.005 and p=0.004, respectively). Although thromboembolic complication had no significant correlated factors, hemorrhagic complication was correlated with pre-PRU (p=0.033). Conclusion : In conclusion, variability of clopidogrel responses during clopidogrel medication was correlated to serum platelet counts and the initial clopidogrel response. Thromboembolic and hemorrhagic complications did not show correlation with the variability of clopidogrel response, or the clopidogrel response after one month of medication; however, hemorrhagic complication was associated with initial clopidogrel response. Therefore, it is recommended to test patients for an initial clopidogrel response only, as further tests would be insignificant.
#Intracranial aneurysm #Stents #Thromboembolism #Platelet aggregation inhibitors

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참고문헌 (30)

참고문헌 신청
Akpek S / 2005 / Selfexpandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience / AJNR Am J Neuroradiol 26:1223~1231 google schola Angiolillo DJ / 2006 / Contribution of gene sequence variations of the hepatic cytochrome P450 3A4 enzyme to variability in individual responsiveness to clopidogrel / Arterioscler Thromb Vasc Biol 26:1895~1900 Crossref Brisman JL / 2006 / Cerebral aneurysms / N Engl J Med 355:928~939 Crossref Delgado Almandoz JE / 2014 / Last-recorded P2Y12 reaction units value is strongly associated with thromboembolic and hemorrhagic complications occurring up to 6 months after treatment in patients with cerebral aneurysms treated with the pipeline embolization device / AJNR Am J Neuroradiol 35:128~135 Crossref Delgado Almandoz JE / 2013 / Pre-procedure P2Y12 reaction units value predicts perioperative thromboembolic and hemorrhagic complications in patients with cerebral aneurysms treated with the pipeline embolization device / J Neurointerv Surg 5(Suppl 3):iii3~iii10 Crossref

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