The benefits of combined anti-platelet treatment in carotid artery stenting
The benefits of combined anti-platelet treatment in carotid artery stenting
复制标题
DOI：
10.1016/j.ejvs.2005.01.012
复制
发表时间：
2005-05-01
影响因子：
5.7
通讯作者：
Venables, GS
中科院分区：
文献类型：
--
作者：
McKevitt, FM;Randall, MS;Venables, GS
客观的。评估阿司匹林和氯吡格雷联合抗血小板方案在颈动脉支架置入术中的益处。方法。进行了一项随机对照试验，比较阿司匹林和 24 小时肝素与阿司匹林和氯吡格雷对接受颈动脉支架置入术的患者的疗效。结果测量包括 30 天出血和神经系统并发症以及 30 天狭窄率。结果。肝素组和氯吡格雷组分别有 17% 和 9% 发生出血并发症（腹股沟血肿或腹股沟部位出血过多）（p = 0.35；n.s）。 24 小时肝素组的神经并发症发生率为 25%，而氯吡格雷组的神经并发症发生率为 0% (p = 0.02)。肝素组 30 天 50-100% 狭窄率为 26%，氯吡格雷组为 5%（p = 0.10；n.s）。结论。双重抗血小板方案对减少不良神经系统结局具有显着影响，且不会额外增加出血并发症。由于试验中肝素组的并发症水平不可接受，该研究提前终止。
Objective. To assess the benefits of a combined anti-platelet regime of aspirin and clopidogrel in carotid artery stenting.Methods. A randomised controlled trial was performed comparing aspirin and 24-h heparin with aspirin and clopidogrel for patients undergoing carotid artery stenting. Outcome measures included 30-day bleeding and neurological complications and 30-day stenosis rates.Results. Bleeding complications (groin haematoma or excessive bleeding at the groin site) occurred in 17% of the heparin and 9% of the clopidogrel group (p = 0.35; n.s). The neurological complication rate in the 24-h heparin group was 25% compared to 0% in the clopidogrel group (p = 0.02). The 30-day 50-100% stenosis rates were 26% in the heparin group and 5% in the clopidogrel group (p = 0.10; n.s).Conclusions. The dual anti-platelet regime has a significant impact on reducing adverse neurological outcomes without an additional increase in bleeding complications. This study was terminated prematurely due to an unacceptable level of complications in the heparin arm of the trial.