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Published on: March 15, 2022

Body weight: a risk factor for subtherapeutic antithrombotic therapy in neurovascular stenting

Doniel Drazin1, Armen Choulakian, Miriam Nuño

  • 1Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Journal of Neurointerventional Surgery
|October 13, 2011
PubMed

Insights

Higher body weight and BMI are linked to suboptimal clopidogrel response in neurovascular stenting. Adjusted dosing may improve antiplatelet therapy and reduce complications.

Area of Science:

  • Neuroendovascular Surgery
  • Cardiovascular Pharmacology

Background:

  • Patients undergoing cervical carotid and intracranial stenting typically receive clopidogrel, aspirin (ASA), and heparin.
  • Optimal antithrombotic therapy levels for these procedures remain undefined.

Purpose of the Study:

  • To evaluate antiplatelet therapy response in patients undergoing neurovascular stenting.
  • To identify factors associated with suboptimal clopidogrel and aspirin response.

Main Methods:

  • Retrospective review of 52 patients undergoing neurovascular stenting.
  • Intraoperative measurements included activating clotting time, ASA reaction units (ARU), and P2Y12 reaction units (PRU).
  • Suboptimal response defined as P2Y12 platelet inhibition <20% or ARU >550.

Main Results:

  • 19 patients (36.5%) exhibited suboptimal clopidogrel response (percentage inhibition).
  • Higher body weight and body mass index were significant predictors of suboptimal response.
  • One intraprocedural thrombosis occurred in the suboptimal group, none in the therapeutic group.

Conclusions:

  • Suboptimal clopidogrel response is associated with increased body weight and BMI in neurovascular stenting patients.
  • Weight-adjusted dosing may optimize antiplatelet therapy and reduce thromboembolic risks.
Abstract

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