Clopidogrel Load for Emboli Reduction in Patients With Symptomatic Carotid Stenosis Undergoing Urgent Carotid Endarterectomy

• DOI: 10.1161/strokeaha.112.657916
• Publication Date: 2012-05-04T05:55:07Z
• Authors: Georgios Tsivgoulis; Antonios Kerasnoudis; Christos Krogias; Konstantinos Vadi...; Saskia H. Meves; Ioannis Heliopoulos; Efstratios Georga...; Charitomeni Piper...; Andrei V. Alexandrov
• Keywords: Interquartile range; Transcranial Doppler; Stroke

Microembolic signals (MES) on transcranial Doppler are an independent risk factor for recurrent stroke in patients with extracranial symptomatic/asymptomatic carotid artery stenosis (CARAS). Clopidogrel load (300 mg) combined dual antiplatelet therapy has been shown to reduce MES symptomatic CARAS. We sought determine feasibility of clopidogrel decreasing asymptomatic embolization CARAS undergoing urgent endarterectomy within the first 2 weeks from index event. Subjects andConsecutive (70%-99%) and presence 1-hour baseline (<24 hours event) monitoring ipsilateral middle cerebral were treated followed by (75 mg)±aspirin (100 during elapsed time period between hospital admission at 3 tertiary-care centers. Repeat was performed day before surgery. Bleeding complications surgery strokes or transient ischemic attacks month ictus prospectively recorded.A total 11 (mean age, 66±7 years; 73% men; 64% acute strokes) (67%) single (33%) therapy. count significantly reduced (median count, 8 MES/h; interquartile range, 6-19) repeat (0 0-3; P=0.003). No bleeding complications, strokes, documented.Our pilot observational study provides preliminary nonrandomized data regarding potential efficacy endarterectomy.