Journal of Korean Neurosurgical Society

  • 제50권1호
  • /
  • Pages.40-44
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  • 2011
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Significance of Clopidogrel Resistance Related to the Stent-Assisted Angioplasty in Patients with Atherosclerotic Cerebrovascular Disease

  • Rho, Gyoung-Jun (Department of Neurosurgery, Presbyterian Medical Center) ;
  • Shin, Woo-Ram (Department of Neurosurgery, Presbyterian Medical Center) ;
  • Kong, Tae-Sik (Department of Neurosurgery, Presbyterian Medical Center) ;
  • Kim, Min-Sun (Department of Radiology, Eulji University Hospital) ;
  • Lee, Chang-Ju (Department of Radiology, Eulji University Hospital) ;
  • Lee, Byung-Hee (Department of Radiology, Eulji University Hospital)
  • 투고 : 2011.02.24
  • 심사 : 2011.07.01
  • 발행 : 2011.07.28
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초록

Objective : To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. Methods : Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : $67.59{\pm}7.10$ years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. Results : Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. Conclusion : There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.

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참고문헌

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