title: Safety and Efficacy of Intensified Antiplatelet Therapy in Patients Undergoing Neuroendovascular Procedures.
abstract: BACKGROUND
  The purpose of this study was to evaluate safety and efficacy of intensified antiplatelet therapy guided by VerifyNow assay P2Y12reaction unit (PRU) reported values in patients undergoing neuroendovascular procedures.
  
  
  METHODS
  An observational, retrospective review was conducted at a single academic tertiary referral center and comprehensive stroke center from December 1, 2012, to August 31, 2014. The primary objective was to determine the prevalence of thromboembolic complications stratified by preprocedural PRU values. Secondary outcomes were assessed by investigating whether the goal PRU value of 190 or less is sufficient to reduce thromboembolic complications on the day of the procedure, and 30- and 90-day postprocedure.
  
  
  RESULTS
  There was no statistically significant difference in the overall rate of complications in the two groups (two events in the group with preprocedural PRU values of 190 or more versus seven events in the group with preprocedural PRU values of less than 190,p= 0.668). Furthermore, the rates of thromboembolic events by 90 days were not significantly different in the two groups (one event in the group with preprocedural PRU ≥ 190 versus four events in patients with preprocedural PRU < 190,p= 1). Similarly, there was no statistically significant difference in the rate of hemorrhagic events in the two groups by 90-day postprocedure (one versus three events,p= 0.558).
  
  
  CONCLUSIONS
  The observed rate of thromboembolic and hemorrhagic complications in patients with preprocedural PRU values of less than 190 was not significantly different from the rate observed in patients with preprocedural PRU values of greater than 190. Sources of funding: No external funding used.
authors.affiliation: Department of Pharmacy, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Senka
authors.initials: S
authors.lastname: Runjaic
authors.affiliation: Department of Pharmacy, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Jerah D
authors.initials: JD
authors.lastname: Nordeen
authors.affiliation: Department of Pharmacy, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Soto-Arenall
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Gretchen S
authors.initials: GS
authors.lastname: Johns
authors.affiliation: Neuroendovascular Division, Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.affiliation: Neuroendovascular Division, Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brown
authors.affiliation: Departments of Neurology, Neurosurgery, and Critical Care, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Freeman