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Switching to prasugrel in clopidogrel poor metabolizers appears safe in small series; leaves open need for prospective confirmation before wider use.
Objective: Recently, dual-antiplatelet therapy (DAPT) including clopidogrel (CLP) with endovascular treatment for unruptured cerebral aneurysm has been widely accepted. However, patients who are poor metabolizers of CLP (CLP-PMs) are more frequent in East Asians than in Caucasians, and an adequate antiplatelet effect may not be achieved with a normal dose in such patients. Prasugrel, which is a novel thienopyridine antiplatelet drug that is less likely to be poorly metabolized than CLP, is used widely for percutaneous coronary intervention, but its efficacy and safety with neuroendovascular treatment have not been elucidated. From this point of view, the purpose of this study was to elucidate the safety and efficacy of prasugrel with endovascular treatment for unruptured cerebral aneurysm.
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Arimura et al. (2017) studied this question.
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