Change of Platelet Aggregation During the Cessation of Antiplatelet Therapy in Patients with Cerebrovascular Reconstruction Surgery

DOI 1 Citations 7 References
  • SATOH Masami
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • MIYAKE Tsuneyo
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • UNO Masaaki
    Department of Neurosurgery, Tokushima University Hospital
  • IKEGAME Akishige
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • YOSHIDA Shinya
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • INOUE Chihiro
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • SHONO Kazuko
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • NAGAMINE Yasunori
    Department of Laboratory Medical Technology Section, Division of Medical Technology, Tokushima University Hospital
  • DOI Toshio
    Department of Laboratory Medicine, Tokushima University Hospital
  • NAGAHIRO Shinji
    Department of Neurosurgery, Tokushima University Hospital

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Other Title
  • 抗血小板薬中止に伴う血小板凝集能の変化―脳血管障害による手術の場合―
  • ―脳血管障害による手術の場合―

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Abstract

We examined how the effects of antiplatelet agents changed after their discontinuation before surgery in terms of platelet aggregation capacity. The study population comprised 35 patients with cerebral ischemia who were about to undergo cerebrovascular reconstruction surgery (Carotid EndoAtherecyomy; 22 patients underwent CEA, and 13 underwent STA-MCA bypass surgery). Preoperatively, they received aspirin (22 patients), clopidogrel (9 patients), or cilostazol (4 patients). The antiplatelet agents were discontinued 3-4 days before surgery and restarted on the day following surgery. On the day of surgery, the percent change rate of the maximum platelet aggregability rate increased to 130% compared with the level during the antiplatelet therapy in the patients receiving aspirin, but it remained as low as 32% in the patients receiving clopidogrel. Almost all patients resumed their pre-discontinuation levels of platelet aggregation after the restart of antiplatelet therapy. None of the 35 patients experienced difficulty in hemostasis during surgery or cerebral infarction or myocardial ischemia during or after surgery. <br> The changes in platelet aggregation rate observed with the use of a selected appropriate inducer reflected patient statuses after discontinuation and restart of antiplatelet therapy. This may be a useful index for monitoring patients undergoing cerebrovascular reconstruction surgery.<br>

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