Cargando…

Eversion endarterectomy under full prasugrel treatment

The third-generation thienopyridine prasugrel has much stronger antiplatelet effect compared to other current antiplatelet inhibitors and exhibits practically zero resistance in healthy people. Prasugrel is used as a pre- and post-treatment in percutaneous coronary or neurovascular interventions wit...

Descripción completa

Detalles Bibliográficos
Autores principales: Kotsis, Thomas, Christoforou, Panagitsa, Asaloumidis, Nikolaos, Argyra, Erifyli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692133/
https://www.ncbi.nlm.nih.gov/pubmed/29163956
http://dx.doi.org/10.1177/2050313X17741826
_version_ 1783279893521367040
author Kotsis, Thomas
Christoforou, Panagitsa
Asaloumidis, Nikolaos
Argyra, Erifyli
author_facet Kotsis, Thomas
Christoforou, Panagitsa
Asaloumidis, Nikolaos
Argyra, Erifyli
author_sort Kotsis, Thomas
collection PubMed
description The third-generation thienopyridine prasugrel has much stronger antiplatelet effect compared to other current antiplatelet inhibitors and exhibits practically zero resistance in healthy people. Prasugrel is used as a pre- and post-treatment in percutaneous coronary or neurovascular interventions with parallel aspirin regime. However, as there is a higher reported bleeding with intraluminal interventions and meticulous technique is recommended, there is nearly non-existent international experience of open surgery under full prasugrel treatment. We present, herein, a case of open carotid endarterectomy with the eversion technique in an asymptomatic patient with carotid stenosis, who was receiving dual antiplatelet therapy with aspirin and prasugrel, due to a previous insertion of two newer drug-eluting stents at the left anterior descending artery and the right coronary artery. The resistance test to prasugrel showed complete inhibition of platelet function. Open surgery was performed under continuation of prasugrel treatment and interruption of aspirin for 3 days before surgery. No perioperative and postoperative neurologic or cardiologic event occurred. No bleeding at the cervical or cerebral area was noted.
format Online
Article
Text
id pubmed-5692133
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-56921332017-11-21 Eversion endarterectomy under full prasugrel treatment Kotsis, Thomas Christoforou, Panagitsa Asaloumidis, Nikolaos Argyra, Erifyli SAGE Open Med Case Rep Case Report The third-generation thienopyridine prasugrel has much stronger antiplatelet effect compared to other current antiplatelet inhibitors and exhibits practically zero resistance in healthy people. Prasugrel is used as a pre- and post-treatment in percutaneous coronary or neurovascular interventions with parallel aspirin regime. However, as there is a higher reported bleeding with intraluminal interventions and meticulous technique is recommended, there is nearly non-existent international experience of open surgery under full prasugrel treatment. We present, herein, a case of open carotid endarterectomy with the eversion technique in an asymptomatic patient with carotid stenosis, who was receiving dual antiplatelet therapy with aspirin and prasugrel, due to a previous insertion of two newer drug-eluting stents at the left anterior descending artery and the right coronary artery. The resistance test to prasugrel showed complete inhibition of platelet function. Open surgery was performed under continuation of prasugrel treatment and interruption of aspirin for 3 days before surgery. No perioperative and postoperative neurologic or cardiologic event occurred. No bleeding at the cervical or cerebral area was noted. SAGE Publications 2017-11-14 /pmc/articles/PMC5692133/ /pubmed/29163956 http://dx.doi.org/10.1177/2050313X17741826 Text en © The Author(s) 2017 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Kotsis, Thomas
Christoforou, Panagitsa
Asaloumidis, Nikolaos
Argyra, Erifyli
Eversion endarterectomy under full prasugrel treatment
title Eversion endarterectomy under full prasugrel treatment
title_full Eversion endarterectomy under full prasugrel treatment
title_fullStr Eversion endarterectomy under full prasugrel treatment
title_full_unstemmed Eversion endarterectomy under full prasugrel treatment
title_short Eversion endarterectomy under full prasugrel treatment
title_sort eversion endarterectomy under full prasugrel treatment
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692133/
https://www.ncbi.nlm.nih.gov/pubmed/29163956
http://dx.doi.org/10.1177/2050313X17741826
work_keys_str_mv AT kotsisthomas eversionendarterectomyunderfullprasugreltreatment
AT christoforoupanagitsa eversionendarterectomyunderfullprasugreltreatment
AT asaloumidisnikolaos eversionendarterectomyunderfullprasugreltreatment
AT argyraerifyli eversionendarterectomyunderfullprasugreltreatment