Key result
Clopidogrel within 8 days of carotid endarterectomy shows no association with increased morbidity or death.
Why the study?
Many patients undergoing carotid endarterectomy regularly take clopidogrel, but the safety regarding bleeding or other complications was uncertain.
Does preoperative clopidogrel use increase bleeding or other complications in patients undergoing carotid endarterectomy?
Cohort (n=182)
Does preoperative clopidogrel use increase bleeding or other complications in patients undergoing carotid endarterectomy?
Preoperative clopidogrel use in patients undergoing carotid endarterectomy appears safe, with only a small increase in operative blood loss and neck swelling when taken within 5 days of surgery, and no increase in permanent morbidity or death.
Supports clopidogrel safety before carotid endarterectomy; leaves open need for randomized confirmation.
OBJECT: Many patients undergoing carotid endarterectomy (CEA) regularly take clopidogrel, a permanent platelet inhibitor. The authors sought to determine whether taking clopidogrel in the period before CEA leads to more bleeding or other complications. METHODS: The authors performed a retrospective, institutional review board–approved review of 182 consecutive patients who underwent CEA. Clinical, radiographic, and surgical data were gleaned from hospital and clinic records. Analysis was based on the presence or absence of clopidogrel in patients undergoing CEA and was performed twice by considering clopidogrel use within 8 days and within 5 days of surgery to define the groups. RESULTS: Taking clopidogrel within 8 days before surgery resulted in no statistical increase in any measure of morbidity or death. Taking clopidogrel within 5 days was associated with a small but significant increase in operative blood loss and conservatively managed postoperative neck swelling. No measure of permanent morbidity or death was increased in either clopidogrel group. CONCLUSIONS: Findings in this study support the safety of preoperative clopidogrel in patients undergoing CEA.
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Wait et al. (2010) conducted a cohort in Carotid endarterectomy (n=182). Clopidogrel vs. Absence of clopidogrel was evaluated on Morbidity or death. Preoperative clopidogrel use within 8 days of carotid endarterectomy resulted in no statistical increase in morbidity or death.
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