Neurointervention.  2019 Mar;14(1):68-70. 10.5469/neuroint.2019.00052.

Low-dose Prasugrel in Patients with Resistance to Clopidogrel for the Treatment of Cerebral Aneurysms: Follow-up of over 6 Months

• Lee D
• Song Y
• Shin JH
• Suh DC

• KMID: 2446785
• DOI: http://doi.org/10.5469/neuroint.2019.00052

Abstract

No abstract available.

MeSH Terms

Follow-Up Studies*
Humans
Intracranial Aneurysm*
Prasugrel Hydrochloride*
Prasugrel Hydrochloride

Figure

• 

  Fig. 1. A thromboembolic event in a patient with 50-kg body weight under aspirin and cilostazol due to clopidogrel resistance. Prasugrel was not prescribed due to low body weight and a history of pontine infarction 2 months ago (A). (B) Incidental aneurysm is found in the anterior communicating artery (white arrow). (C) Pre- and (D) post-embolization cerebral angiograms. Stent-assisted coil embolization was performed for the aneurysm (black arrow). (E) Diffusion-weighted image shows an acute infarction in the anterior cerebral artery territory. (F) Magnetic resonance angiography shows a faint filling of the anterior cerebral artery. Revascularization was not tried. Final modified Rankin Scale score was 2 at 90 days.

Reference

1. Lee D, Song Y, Han M, Park D, Suh DC. Low-dose prasugrel in patients with resistance to clopidogrel for the treatment of cerebral aneurysms. Neurointervention. 2018; 13:124–127.

2. Choi HH, Lee JJ, Cho YD, Han MH, Cho WS, Kim JE, et al. Antiplatelet premedication for stent-assisted coil embolization of intracranial aneurysms: low-dose prasugrel vs clopidogrel. Neurosurgery. 2018; 83:981–988.

3. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007; 357:2001–2015.

4. Sedat J, Chau Y, Gaudart J, Sachet M, Beuil S, Lonjon M. Prasugrel versus clopidogrel in stent-assisted coil embolization of unruptured intracranial aneurysms. Interv Neuroradiol. 2017; 23:52–59.