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Published on: March 15, 2022

Dual antiplatelet regime versus acetyl-acetic acid for carotid artery stenting

Ilias Dalainas1, Giovanni Nano, Paolo Bianchi

  • 1Istituto Policlinico San Donato, 1st Unit of Vascular Surgery, University of Milan, Milan, Italy. hdlns@freemail.gr

Cardiovascular and Interventional Radiology
|March 28, 2006
PubMed

Insights

Dual antiplatelet therapy significantly reduced neurological complications after carotid artery stenting compared to heparin. This approach is recommended for patients undergoing this procedure to improve safety outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Neurology

Background:

  • Carotid artery stenosis poses a significant risk for stroke.
  • Carotid artery stenting (CAS) is an established treatment for symptomatic stenosis.
  • Optimizing anti-thrombotic therapy post-CAS is crucial for patient outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of dual-antiplatelet therapy (DAPT) versus heparin combined with acetylsalicylic acid post-CAS.
  • To evaluate neurological and bleeding complications, as well as thrombosis rates within 30 days.

Main Methods:

  • A single-institution study comparing two groups of 50 patients each undergoing CAS for atherosclerotic disease.
  • Group A: Heparin (24h) + Acetylsalicylic Acid (ASA).
  • Group B: Ticlopidine + ASA.

Main Results:

  • Neurological complications were significantly lower in the DAPT group (2%) compared to the heparin group (16%) (p < 0.05).
  • Bleeding complications (4% vs 2%) and 30-day thrombosis/occlusion rates (2% vs 0%) showed no significant difference between groups.
  • The DAPT regimen demonstrated a favorable safety profile regarding neurological events.

Conclusions:

  • Dual antiplatelet therapy with ticlopidine and acetylsalicylic acid is associated with a significant reduction in neurological complications following carotid artery stenting.
  • DAPT is recommended for patients undergoing CAS to minimize the risk of stroke and other neurological events.

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