Response to Letter by García Martín et al

• DOI: 10.1161/strokeaha.107.508358
• Publication Date: 2007-12-28T01:44:20Z
• Authors: Daniel Periard; Stephan Eyer; Chantal M. Boulanger; Mahmut Ozsahin; Daniel Hayoz
• Keywords: Garcia; Angiology

Response: We read with great interest the letter by Garcia Martin and colleagues reporting a case of cisplatin-induced stroke with vertebral artery occlusion.1 Multiple simultaneous or recurrent cerebral infarctions have been observed after cisplatin infusion in young patients, suggesting a pathogenesis distinct from other types of strokes.2 We recently postulated a mechanism of direct endothelial cell lesion induced by cisplatin, with release of prothrombotic fragments of endothelial cell in the circulation, causing further platelet and coagulation activation.3 We demonstrated that cisplatin induces in patients with cancer a rapid and brief decrease in the level of circulating endothelial or platelet-derived microparticles (MPs), followed by an increase of these MPs with successive cisplatin infusions.3 These bimodal kinetics may be consecutive to a brief increase in MPs clearance by liver Kupfer …