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Antiplatelet Drugs for Neurointerventions: Part 1 Clinical Pharmacology

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Abstract

The development of endovascular treatment for intracranial aneurysms has established new techniques such as balloon and stent-assistance, flow diversion and endosaccular occlusion devices. Antiplatelet treatment is an important aspect to reduce risk of thrombus formation on microcatheters and implanted devices when utilizing these methods. It is particularly relevant for flow diverting stents to prevent early and late stent thrombosis. Consideration of platelet physiology and appropriate selection of antiplatelet medication is important as platelet dysfunction drives many of the pathological processes and complications of neurointerventional procedures. Part one of this review focuses on basic platelet physiology, pharmacology of common antiplatelet medications and future directions and therapies. Part two focuses on clinical applications and evidence-based therapeutic regimens.

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Authors and Affiliations

  1. Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia

    Samuel Pearce, Julian T. Maingard, Kenny Li, Ronil V. Chandra & Hamed Asadi

  2. School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia

    Julian T. Maingard, Hong Kuan Kok, Mark Brooks & Hamed Asadi

  3. Interventional Radiology Service, Department of Radiology, Northern Hospital, Melbourne, Victoria, Australia

    Hong Kuan Kok

  4. South Australian Institute of Health and Medical Research, Adelaide, South Australia, Australia

    Christen D. Barras

  5. School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia

    Christen D. Barras

  6. Department of Neurosurgery, Austin Health, Melbourne, Victoria, Australia

    Jeremy H. Russell

  7. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Joshua A. Hirsch

  8. Department of Imaging, Monash University, Melbourne, Victoria, Australia

    Ronil V. Chandra

  9. Interventional Neuroradiology, St Vincent’s Hospital, Melbourne, Victoria, Australia

    Ash Jhamb

  10. Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia

    Vincent Thijs, Mark Brooks & Hamed Asadi

  11. School of Medicine, University of Melbourne, Melbourne, Victoria, Australia

    Vincent Thijs, Mark Brooks & Hamed Asadi

  12. Department of Neurology, Austin Health, Melbourne, Victoria, Australia

    Vincent Thijs

  13. Interventional Neuroradiology service, Radiology Department, Austin Health, Melbourne, Victoria, Australia

    Mark Brooks & Hamed Asadi

  14. 8/5 Grosvenor Street, 3108, Doncaster, Victoria, Australia

    Samuel Pearce

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Correspondence to Samuel Pearce.

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S. Pearce, J.T. Maingard, K. Li, H.K. Kok, C.D. Barras, J.H. Russell, J.A. Hirsch, R.V. Chandra, A. Jhamb, V. Thijs, M. Brooks, H. Asadi and declare that they have no competing interests.

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Pearce, S., Maingard, J.T., Li, K. et al. Antiplatelet Drugs for Neurointerventions: Part 1 Clinical Pharmacology. Clin Neuroradiol 30, 425–433 (2020). https://doi.org/10.1007/s00062-020-00910-5

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