Platelet aggregation in intracranial stents may mimic in-stent restenosis.
We report the case of an early ISR that was due to platelet aggregation despite correct observance of a standard antiplatelet regimen. Biologic testing showed clopidogrel inefficiency, and ISR disappeared on angiography after a loading dose of clopidogrel. This result suggested that the arterial lumen reduction was due to platelet aggregation rather than in-stent myointimal hyperplasia. This observation emphasizes the importance of verifying the efficacy of clopidogrel before placing a stent.
Mazighi
M
M
Service de Neuroradiologie Diagnostique et Interventionnelle, Hopital Lariboisiere, Paris, France.
Saint Maurice
J P
JP
Bresson
D
D
Szatmary
Z
Z
Houdart
E
E
D002533:Cerebral Angiography; D000077144:Clopidogrel; D003937:Diagnosis, Differential; D004351:Drug Resistance; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017211:Treatment Failure
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine