Key result
Clopidogrel and prasugrel resistance triggers hyperacute in-stent thrombosis after aneurysm coiling despite DAPT compliance.
Why the study?
Dual antiplatelet therapy is standard treatment for endoluminal stent insertion, but complete resistance to DAPT is rare.
Highlights a rare case of hyperacute in-stent thrombosis caused by complete resistance to both clopidogrel and prasugrel following stent-assisted aneurysm coiling.
Answers are grounded in this paper and cite their sources.
May indicate DAPT resistance in acute post-coiling thrombosis; leaves open role of routine PFTs in neurovascular stenting.
Dual antiplatelet therapy (DAPT) is standard treatment for endoluminal stent insertion, and complete resistance to DAPT is rare. A case of in-stent thrombosis occurring 3 hours after stent-assisted coiling of internal carotid artery aneurysm is presented despite compliance with DAPT. Platelet function tests (PFTs) revealed complete clopidogrel and prasugrel resistance.
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Xian et al. (2022) studied this question. Complete clopidogrel and prasugrel resistance led to hyperacute in-stent thrombosis and large vessel occlusion 3 hours after stent-assisted aneurysm coiling despite DAPT compliance.
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