Carotid artery stenting under dual antiplatelet therapy using prasugrel: a novel antiplatelet agent

● Abstract● Objective: Dual antiplatelet therapy is recommended for carotid artery stenting (CAS) to prevent ischemic complications. We report a case of CAS where the novel antiplatelet agent, prasugrel, was used because multiple antiplatelet agents were unavailable. Case presentation: A 70-year-old man presented with minor stroke associated with cervical carotid artery stenosis. CAS was considered appropriate as a cerebral revascularization therapy. However, both clopidogrel and cilostazol were contraindicated because they were suspected as causes of agranulocytosis. We performed CAS under dual antiplatelet therapy with aspirin and prasugrel. His postoperative course was uneventful. Conclusion: We described a successful CAS performed under dual antiplatelet therapy including prasugrel, in Japan. Further investigations would be warranted to address the safety and efficacy of prasugrel in neuroendovascular therapy.