Document Detail


Periprocedural drug therapy in carotid artery stenting: the need for more evidence.
MedLine Citation:
PMID:  19344586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Carotid artery stenting (CAS) is a widely accepted alternative for patients at high risk for carotid endarterectomy (CEA). However, the role, indications, and evidence for many pharmacologic agents that are used adjunctively in the periprocedural setting have not been established. Several drugs are commonly used before, during, and after CAS, but their uses have not been standardized. Large prospective cohort studies with good validity or randomized trials are needed to demonstrate efficacy, predict outcome, and determine the optimal use of these medications in patients undergoing CAS to improve patient care and obtain optimal outcomes. Several conclusions can be made: (1) dual-antiplatelet therapy (aspirin and clopidogrel) is commonly used for CAS; (2) the most commonly used regimen is aspirin 325 mg and clopidogrel 75 mg per day, but the optimal time of therapy is unknown; and (3) the dose and regimen of other agents used for CAS are not established.
Authors:
David Gortler; Felix J V Schlösser; Bart E Muhs; Michael A Nelson; Alan Dardik
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Vascular     Volume:  16     ISSN:  1708-5381     ISO Abbreviation:  Vascular     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2009-04-06     Completed Date:  2009-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196722     Medline TA:  Vascular     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  303-9     Citation Subset:  IM    
Affiliation:
Department of Pharmacology, Yale University School of Medicine, New Haven, CT 06520-8089, USA.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use*
Aspirin / therapeutic use
Atropine / therapeutic use
Carotid Arteries / surgery*
Carotid Stenosis / surgery*
Heparin / therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Platelet Aggregation Inhibitors / therapeutic use*
Premedication / methods*
Stents*
Ticlopidine / analogs & derivatives,  therapeutic use
Warfarin / therapeutic use
Grant Support
ID/Acronym/Agency:
HL079927/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 51-55-8/Atropine; 55142-85-3/Ticlopidine; 81-81-2/Warfarin; 9005-49-6/Heparin; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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