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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 833 920 Interventional neurology Significance of clopidogrel resistance related to the stent-assisted angioplasty in patients with atherosclerotic cerebrovascular disease B.H. Lee1, Y.J. Choi2, H.G. Lee3, J.S. Kang4 Dept.of Radiology Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA1, Dept.of Neurol-ogy, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA2, Dept. of Neurosurgery, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA3, Dept. of Neurosurgery, Cheonan ChungMu Hos-pital, Cheonan, SOUTH KOREA4 Background:To evaluate the prevalence, risk factor, clinical and radiographic outcomes of clopido-grel resistance in patient with stenting for atherosclerotic cerebrovascular disease. Materials and Methods:Between Sep.2006 and June 2008, clopidogrel resistance test was performed on 43 patients who underwent stenting for atherosclerotic cerebrovascular disease. Clopidogrel re-sistance test was performed about 12 hours after drug administration(loading dose:300mg, main-tanance dose: 75mg).41 patients were included(range: 41-79, mean: 65.9 years). Among 41 patients, 18 patients showed intracranial lesions, and 23 patients had extracranial lesions.We evaluate the prevalence, risk factors and complications related to clopidogrel resistance. Results:21 patients (51.2%) presented clopidogrel resistance(intracranial:10 patients (55.6%),extra-cranial: 11 patients(47.8%)) with no clopidogrel resistance in 20 patients. Stent-assisted angioplasty was technically successful in all patients, but acute instent thrombosis occurred in 5 patients with intracranial lesion(four patients with clopidogrel resistance and one patient without clopidogrel re-sistance). Acute thrombi were completely lysed after IA infusion of abciximab. Patients with clopi-dogrel resistance showed relatively higher incidence of dyslipidemia than non-resistance patients. Conclusion : There is high prevalence of clopidogrel resistance in patients with atherosclerotic cere-brovascular disease. Acute instent thrombosis is more frequently seen in the clopidogrel resistant group. So, clopidogrel resistance test should be necessary to avoid thromboembolic complications related to acute instent thrombosis. 921 Interventional neurology Neurointerventional treatment in acute stroke. Whom to treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection) L. Fjetland1, S. Roy2, K.D. Kurz3, T. Solbakken4, J.P. Larsen5, M.W. Kurz6 Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY1, Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY2, Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY3, Department of Neurology, Stavanger Uni-versity Hospital, Stavanger, NORWAY4, Department of Neurology, Stavanger University Hospital, Stavanger, NORWAY5, Department of Neurology, Stavanger University Hospital, Stavanger, NOR-WAY6 PURPOSE: Intraarterial therapy (IAT) is increasingly used as treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluate the Houston IAT (HIAT) and the Totaled Health Risks in Vascular Events (THRIVE) score, two predicting scores designed to identify patients likely to bene-fit from IAT. MATERIALS AND METHODS: All patients treated at the Stavanger University Hos-pital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy. RESULTS: 52 patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p=0.002, HIAT p=0.003). The correlations were limited to patients successfully recanalized and to patients < 80 years. By combining the scores additional 14.3% of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. CONCLUSIONS: Both scores showed a strong correlation to poor clinical outcome in patients < 80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients ≥ 80 years.


Karger_ESC London_2013
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