Platelet aggregation in intracranial stents may mimic in-stent restenosis

M Mazighi; J P Saint Maurice; D Bresson; Z Szatmary; E Houdart

doi:10.3174/ajnr.A1778

Platelet aggregation in intracranial stents may mimic in-stent restenosis

AJNR Am J Neuroradiol. 2010 Mar;31(3):496-7. doi: 10.3174/ajnr.A1778. Epub 2009 Oct 15.

Authors

M Mazighi¹, J P Saint Maurice, D Bresson, Z Szatmary, E Houdart

Affiliation

¹ Service de Neuroradiologie Diagnostique et Interventionnelle, Hopital Lariboisiere, Paris, France.

Abstract

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.

Publication types

Case Reports

MeSH terms

Cerebral Angiography
Clopidogrel
Diagnosis, Differential
Drug Resistance
Graft Occlusion, Vascular / diagnostic imaging*
Graft Occlusion, Vascular / drug therapy
Humans
Male
Middle Aged
Platelet Aggregation / drug effects*
Platelet Aggregation Inhibitors / therapeutic use*
Stents / adverse effects*
Ticlopidine / analogs & derivatives*
Ticlopidine / therapeutic use
Treatment Failure

Substances

Platelet Aggregation Inhibitors
Clopidogrel
Ticlopidine